Open Access
ARTICLE
Use of Implantable Cardioverter-Defibrillators in Congenital Heart Disease and Pediatric Patients: Results from the German National Registry for Congenital Heart Defects
Coralie Katharina Dicks1, Gerhard-Paul Diller1, Kristina Wasmer2, Paul C. Helm3,4, Ulrike M. M. Bauer3,4, Helmut Baumgartner1, Stefan Orwat1,#, Alicia Jeanette Fischer1,#,*
1 Department of Cardiology III-Adult Congenital and Valvular Heart Disease, University Hospital of Muenster, Muenster, Germany
2 Department of Cardiology II-Electrophysiology, University Hospital of Muenster, Muenster, Germany
3 National Register for Congenital Heart Defects, Berlin, Germany
4 Deutsches Zentrum für Herz-Kreislauf-Forschung, Berlin, Germany
* Corresponding Author: Alicia Jeanette Fischer. Email:
# Shared Authorship
Congenital Heart Disease 2020, 15(2), 117-125. https://doi.org/10.32604/CHD.2020.011520
Received 14 May 2020; Accepted 22 June 2020; Issue published 23 June 2020
Abstract
Background: Sudden cardiac death is a leading cause of death in
patients with congenital heart disease (CHD). Risk stratification for implantable
cardioverter defibrillators (ICD) remains difficult due to limited data about use
and outcome of device therapy in CHD patients in larger community-based
cohorts.
Methods and results: Out of a dataset with more than 50,000 patients
registered at the German National Register for Congenital Heart Defects, 109
patients (median age 35.5; IQR 23.75–46.00), 68 (62%) male) with an ICD were
identified and were retrospectively analyzed. Although the number of
implantations increased steadily throughout the investigated time interval from
2001 to 2015, only 0.2% of the CHD patients in the national register received an
ICD. Indication for ICD implantation was secondary prevention in 84 patients
(78%) and primary prevention in 24 patients (22%). 23 patients (21%) of the ICD
patients received appropriate ICD therapy. 7 patients (6%) received an
inappropriate ICD therapy. In 23 patients (21%) device complications were
documented with a high number of lead fractures and insulation defects (n = 14,
13%).
Conclusion: The current study investigates the clinical uptake and use of
ICD therapy based on a large national registry for CHD patients. Despite a steady
increase in the number of implanted devices, ICD uptake remains relatively low,
particularly for primary prevention. The data suggests a potential reluctance in
utilization of device therapy in this patient cohort for primary prevention.
Selecting patients in whom benefits outweigh the risks associated with lifelong
ICD therapy remains challenging.
Keywords
Cite This Article
Dicks, C. K., Diller, G., Wasmer, K., Helm, P. C., M., U. et al. (2020). Use of Implantable Cardioverter-Defibrillators in Congenital Heart Disease and Pediatric Patients: Results from the German National Registry for Congenital Heart Defects.
Congenital Heart Disease, 15(2), 117–125. https://doi.org/10.32604/CHD.2020.011520
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