@Article{CHD.2020.011520,
AUTHOR = {Coralie Katharina Dicks, Gerhard-Paul Diller, Kristina Wasmer, Paul C. Helm, Ulrike M. M. Bauer, Helmut Baumgartner, Stefan Orwat, Alicia Jeanette Fischer},
TITLE = {Use of Implantable Cardioverter-Defibrillators in Congenital Heart Disease  and Pediatric Patients: Results from the German National Registry for  Congenital Heart Defects},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {2},
PAGES = {117--125},
URL = {http://www.techscience.com/schd/v15n2/39431},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> 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. <b>Methods and results:</b> 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%). <b>Conclusion:</b> 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.},
DOI = {10.32604/CHD.2020.011520}
}