Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Endowed Professor
Language English
Title Outcome of Transvenous Cardiac Implantable Electronic Devices Implantation for Adults with Complex Congenital Heart Disease
Conference The 81st Annual Scientific Meeting of the Japanese Circulation Society (JCS2017)
Promoters Japanese Circulation Society
Conference Type Nationwide Conferences
Presentation Type Speech
Publisher and common publisher◎TAKEUCHI Daiji, HENMI Ryuta, IWANAMI Yuji, TOYOHARA Keiko, SHODA Morio, HAGIWARA Nobuhisa
Date 2017/03/18
(city and name of the country)
Kanazawa, JAPAN
Society abstract PROGRAM JCS 2017 310
Summary Background: Bradycardia, malignant ventricular tachyarrhythmia, cardiac dysfunction are important late complications after repair in adult congenital heart disease (CHD). Although the number of cardiac implantable electronic device (CIED) implantation for adults CHD is increasing, transvenous CIED implantation for complex CHD is still challenging because of its unique anatomy and physiology.
Aim: To investigate the outcome of CIED implantation for complex CHD in a single center.
Results: We studied retrospectively total 117 adult patients with moderate to complex CHD after cardiac operation, who underwent transvenous CIED implantation: 60 pacemaker (PM), 44 implantable cardioverter defibrillator (ICD) and 13 cardiac resynchronized therapy (CRT). We performed catheter intervention for 3 patients before CIED implantation (stent dilatation for superior vena cava (SVC) stenosis after Mustard operation in 1 and atrial septal occlusion in 2). We used 3D mapping system (NavX) in 10 patients during CIED implantation to delineate low voltage lesions. Although all PM and ICD were successfully implanted, CRT implantation was failed in 3 out of 13 patients due to coronary vein anomaly. Acute and chronic complications associated with CIED occurred in 13% (n=16): 5 hematomas, 11 lead failures (2 recalled ICD leads), 1 SVC occlusion and 1 device infection. Lead extraction was performed in 2 patients. 61 patients (52%) were monitored remotely for early detection of CIED-based problems. There was no device related mortality.
Conclusion: The clinical outcome of transvenous CIED in complex adult CHD after intracardiac repair was considered acceptable in spite of relatively high incidence of implantation failure and complications.