Device complications in adult congenital heart disease

Heart Rhythm. 2015 Feb;12(2):338-44. doi: 10.1016/j.hrthm.2014.10.038. Epub 2014 Oct 31.

Device complications in adult congenital heart disease.

Hayward RM1Dewland TA1Moyers B1Vittinghoff E2Tanel RE3Marcus GM1Tseng ZH4.

Comment: In this study, Hayward and colleagues seek to compare pacemaker and ICD implantation complication rates between adults with and those without congenital heart disease.  Using a comprehensive database search in California, the authors identified all patients 18 years and older receiving a new pacemaker or ICD.  138,800 adult patients receiving devices were included, 2433 of which had a diagnosis of CHD (153 noted to be complex).  With pacemakers, after multivariate analysis, CHD was not associated with increased risk of complications; there was a trend toward lower 30-day in-hospital mortality in CHD.  With ICDs, CHD was associated with an increased risk of implant-related complications and complex CHD was associated with a significantly increased risk.  These included mechanical complications, device infections and repeat procedures.  No increase in complications was found with epicardial devices.  This is the largest study of its kind published to date.