Clinical research Arrhythmia/electrophysiology Outcome of implantable cardioverter defibrillators in adults with congenital heart disease: a multi-centre study

Aims To investigate outcome and complications of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) and to identify predictors of (in-) appropriate shocks. Methods and results Sixty-four CHD patients 18 years at first ICD implantation [63 % tetralogy of Fallot (TOF) and age at implantation 37+ 13 years] were identified using the Dutch adult CHD registry and a Belgian tertiary care centre database. Median follow-up duration was 3.7 years. Early complications included pocket haematoma (n 3), lead failure (n 2), and pneumothorax (n 2). Late complications occurred in 11 (17%) patients, including lead failure (n 6) and and electrical storm (n 3). Overall, 30 device-related re-interventions were performed in 20 patients (31%), including four premature genera-tor changes and seven lead replacements. Half of the patients received one or more shocks, and 46 shocks in 15 patients (23%) were classified as appropriate. One hundred and sixty shocks in 26 patients (41%) were classified as inappropriate. No predictors of (in-)appropriate shocks were identified, except TOF being associated with less appropriate shocks than patients with other CHD (HR 0.29, P 0.02)