[Rhythm therapy for congenital heart defects with implantable electronic devices]

Patients with congenital heart defects have an increased indication rate for pacemaker systems and implantable cardioverter defibrillators (ICD), which however are not designed for children. Therefore, the combination of selected materials is essential for long-term and safe therapy. Epimyocardial systems are the best option for neonates and infants, as well as patients with Fontan circulation who do not have systemic venous access to the heart. For most other patients, transvenous systems are advantageous because the leads and batteries last longer and are easier to adjust as the patient grows. To avoid vascular complications, only the thinnest leads should be used and broken leads should be explanted. Telemetric monitoring is urgently indicated for these patients in order to detect rhythm or system disturbances at an early stage.