Pacing in congenital heart disease – A four-decade experience in a single tertiary centre
| Autor: | Tom Wong, Karen Lascelles, Disha Midha, K Dimopoulos, Julian W.E. Jarman, Jonathan R. Clague, Zhong Chen, Howell J. Williams, Sonya V. Babu-Narayan, David G. Jones, Michael A. Gatzoulis, Vias Markides, Janice A. Till |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Heart Defects Congenital Male Pacemaker Artificial Pediatrics medicine.medical_specialty Time Factors Multivariate analysis Adolescent Heart disease Long QT syndrome Population 030204 cardiovascular system & hematology Tertiary Care Centers Young Adult 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans 030212 general & internal medicine education Normal heart Retrospective Studies education.field_of_study business.industry Cardiac Pacing Artificial Guideline medicine.disease Increased risk Cardiology Female Cardiology and Cardiovascular Medicine Complication business Follow-Up Studies |
| Zdroj: | International Journal of Cardiology. 241:177-181 |
| ISSN: | 0167-5273 |
| DOI: | 10.1016/j.ijcard.2017.02.151 |
| Popis: | Background The increased risk of brady- and tachy-arrhythmias in the congenital heart disease (CHD) population means that cardiac rhythm management devices are often required at an early age and expose patients to device-related complications. The present study drew upon four decades of experience at a tertiary adult congenital heart disease ACHD center and aimed to investigate the indication for cardiac implantable electronic devices (CIEDs) and predictors of late device-related complication requiring re-intervention. Methods A retrospective review of pacing records of ACHD patients over forty years was carried out. The primary outcome measure was device related complication requiring re-intervention. Results Between 1970 and 2009, 238 structural CHD patients who received CIEDs with follow-up data were identified (structural group). As a comparator group, 98 patients with congenital conduction disease or long QT syndrome with a structurally normal heart (electrical group) were included in the study. During a mean follow-up of 9.6±8.5years, 72 (21%) patients (44 structural group, 28 electrical group) required ≥1 re-intervention due to device related complications. Multivariate analysis showed that age at the time of device implant was an independent predictor of late device-related complications (HR 0.77, 95% CI 0.60–0.98, p=0.04). Sub-analysis of the structural group showed that ACHD complexity (Bethesda guideline) was the only predictor late device-related complication in the structural group (HR 2.96, 95% CI: 1.67–5.26, p Conclusion Increasing age at device implant was inversely associated with late device-related complications. ACHD patients with complex anatomy are at increased risk of device-related complications at mid and long-term follow-up. |
| Databáze: | OpenAIRE |
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