@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 = {Congenital Heart Disease},
VOLUME = {15},
YEAR = {2020},
NUMBER = {2},
PAGES = {117--125},
URL = {http://www.techscience.com/chd/v15n2/39431},
ISSN = {1747-0803},
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.},
DOI = {10.32604/CHD.2020.011520}
}