Key result
Implantable cardioverter-defibrillators are an important therapy for preventing sudden cardiac death in adults with congenital heart disease, though identifying appropriate candidates for primary prevention remains challenging.
Why the study?
Does implantable cardioverter-defibrillator prevent sudden cardiac death in adults with congenital heart disease?
Does implantable cardioverter-defibrillator prevent sudden cardiac death in adults with congenital heart disease?
While ICDs are established for secondary prevention of sudden cardiac death in adult congenital heart disease, primary prevention requires individualized risk stratification based on specific anatomic subtypes like TOF and TGA.
Supports secondary prevention ICD use in adult congenital heart disease; leaves open primary prevention risk stratification.
With improved surgical techniques and medical therapies, many patients who are born with complex congenital heart defects are now living well into adulthood. As these patients age, an increasingly common cause of mortality is sudden cardiac death (SCD) from ventricular tachyarrhythmias. The implantable cardioverter-defibrillator (ICD) is a therapy with the ability to prevent some of these deaths; however, there are many diagnostic and technical challenges that remain in the congenital heart disease (CHD) population. We performed a literature review, searching PubMed for articles that examined the role of ICDs in CHD. We herein present the evidence for when to place an ICD in CHD patients, stratified by subtype as relevant. Then, we discuss the technical challenges and complications that are unique to this patient population. We conclude that, despite active work in the area, more research is needed given the small event rates and clinical variability within CHD populations.
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Stewart et al. (2018) conducted a review in Adult Congenital Heart Disease. Implantable Cardioverter-defibrillators (ICD) was evaluated. Implantable cardioverter-defibrillators are an important therapy for preventing sudden cardiac death in adults with congenital heart disease, though identifying appropriate candidates for primary prevention remains challenging.
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