title: Electrophysiology procedures in adults with congenital heart disease.
abstract: BACKGROUND
  In adult congenital heart disease (CHD), arrhythmias contribute significantly to morbidity and mortality. Often, these adult patients are treated at a freestanding pediatric facility. Limited data exist looking at this cohort.
  
  
  METHODS
  A retrospective review was performed of all electrophysiology (EP) procedures performed in adults at our institution during a 5-year period from January 1, 2006 through December 31, 2010.
  
  
  RESULTS
  There were 99 cases performed in a total of 87 adults with CHD during this time period. The mean patient age was 27.1 years (18-51 years). The most common congenital cardiac diagnoses were: 27% with D-transposition of the great arteries (n = 27)-of which 85% (n = 23) have had a previous atrial switch procedure, 20% with tetralogy of Fallot (n = 20), and 16% with previous Rastelli repair (n = 16). Overall, 37 EP studies were performed, with the majority done in patients with complex CHD. There were 74 additional cases. These procedures consisted of: 38 pacemakers (51%), 26 implantable cardiac defibrillators (36%), six laser lead extractions (8%), two loop recorders (3%), and two pocket revisions (3%). During this 5-year period, there was one major complication (1%) and seven minor complications (7%).
  
  
  CONCLUSIONS
  The complex care of adults with CHD requiring EP procedures can be safely and effectively accomplished in a freestanding pediatric hospital with low complications, provided institutional support of an adult CHD program.
authors.affiliation: Department of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030, USA. permis@bcm.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Ermis
authors.forename: Wayne
authors.initials: W
authors.lastname: Franklin
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Kim
authors.forename: Douglas
authors.initials: D
authors.lastname: Moodie
authors.forename: Dhaval
authors.initials: D
authors.lastname: Parekh
mesh_terms: D000293:Adolescent; D000328:Adult; D022062:Electrophysiologic Techniques, Cardiac / Q000706:statistics & numerical data*; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000628:therapy*; D006331:Heart Diseases / Q000151:congenital* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult