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Complications of pacemaker therapy in adults with congenital heart disease: a multicenter study

Petra Opić1, Matthijs van Kranenburg, Sing-Chien Yap

  • 1Department of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.

International Journal of Cardiology
|May 7, 2013
PubMed

Insights

Adults with congenital heart disease (CHD) face higher risks of pacemaker complications. Early implantation increases these risks, with over a third experiencing issues long-term.

Area of Science:

  • Cardiology
  • Medical Devices
  • Congenital Heart Disease

Background:

  • Permanent cardiac pacing is crucial for managing arrhythmias in adults with congenital heart disease (CHD).
  • Understanding the specific indications and complication profiles for pacemaker implantation in this unique population is essential for optimizing patient care.
  • Long-term outcomes and risk factors associated with pacemakers in CHD patients require further investigation.

Purpose of the Study:

  • To investigate the indications for permanent pacemaker implantation in adults with congenital heart disease (CHD).
  • To assess the incidence and types of periprocedural and long-term pacemaker-related complications in CHD patients.
  • To identify predictors of pacemaker complications in this population.

Main Methods:

  • Retrospective analysis of 274 adult CHD patients who underwent permanent pacemaker implantation between 1972 and 2009.
  • Categorization of indications for pacing, including conduction disease and surgical complications.
  • Comparison of complication rates and types between CHD patients and the general population, and identification of risk factors for late complications.

Main Results:

  • The primary indications for pacing were conduction disease (63%) and post-surgical conduction issues (28%).
  • CHD patients received pacemakers at a younger age and more frequently had epicardial systems compared to those with less complex CHD.
  • Periprocedural complication rates were higher in CHD patients (10.6%) versus the general population (5.2%), with lead dysfunction being common.
  • Long-term follow-up revealed pacemaker-related complications in 34.6% of patients, with lead failure being the most frequent late complication.
  • Pacemaker implantation at a younger age (<18 years) was an independent predictor of late pacemaker-related complications.

Conclusions:

  • Permanent pacemaker implantation in adults with CHD is associated with a higher risk of periprocedural complications compared to the general population.
  • Over one-third of CHD patients experience pacemaker-related complications during long-term follow-up, highlighting the need for vigilant monitoring.
  • Younger age at pacemaker implantation is a significant risk factor for developing late pacemaker-related complications in adults with CHD.
Abstract

Keywords:
ComplicationCongenital heart diseaseLead failurePacemakerTetralogy of FallotTransposition of the great arteries

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