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Implantation of Total Artificial Heart in Congenital Heart Disease
07:27

Implantation of Total Artificial Heart in Congenital Heart Disease

Published on: July 18, 2014

25.4K

Device complications in adult congenital heart disease

Robert M Hayward1, Thomas A Dewland1, Brian Moyers1

  • 1Section of Cardiac Electrophysiology, Division of Cardiology, Department of Medicine, University of California, San Francisco, California.

Heart Rhythm
|December 3, 2014
PubMed

Insights

Adults with congenital heart disease (CHD) face a higher risk of complications from implantable cardioverter-defibrillator (ICD) procedures, but not from pacemakers. This study analyzed device implantation risks in California adults with and without CHD.

Area of Science:

  • Cardiology
  • Medical Device Technology
  • Public Health

Background:

  • Increasing use of pacemakers and implantable cardioverter-defibrillators (ICDs) in adults with congenital heart disease (CHD).
  • Limited data on implant-related complications and mortality in this growing patient population.

Purpose of the Study:

  • To compare complication rates of pacemaker and ICD implantation in adults with and without CHD.
  • Utilize a comprehensive statewide database for robust analysis.

Main Methods:

  • Analysis of the Healthcare Cost and Utilization Project database (2005-2011) for initial transvenous device implantations in California.
  • Comparison of implant-related complications between adults with and without CHD using Poisson regression, adjusting for age and comorbidities.

Main Results:

  • No increased risk of pacemaker implant complications for adults with CHD (aRR 0.92, P = .45).
  • Increased risk of ICD implant complications for adults with CHD (aRR 1.36, P = .02), with higher risk for complex CHD (aRR 2.14, P = .02).
  • Trend towards lower 30-day in-hospital mortality after device implantation in patients with CHD.

Conclusions:

  • Congenital heart disease (CHD) is linked to increased risk of implantable cardioverter-defibrillator (ICD) complications, but not pacemaker complications.
  • No association between CHD and higher 30-day in-hospital mortality following device implantation.
  • Findings highlight specific risks for ICDs in adults with CHD requiring careful consideration.
Abstract

Keywords:
Congenital heart diseaseImplantable cardioverter-defibrillatorPacemaker

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