Electrophysiology procedures in adults with congenital heart disease

Congenit Heart Dis. 2012 Jul-Aug;7(4):344-8. doi: 10.1111/j.1747-0803.2012.00658.x. Epub 2012 Apr 27.


Background: In adult congenital heart disease (CHD), arrhythmias contribute significantly to morbidity and mortality. Often, these adult patients are treated at a freestanding pediatric facility. Limited data exist looking at this cohort.

Methods: A retrospective review was performed of all electrophysiology (EP) procedures performed in adults at our institution during a 5-year period from January 1, 2006 through December 31, 2010.

Results: There were 99 cases performed in a total of 87 adults with CHD during this time period. The mean patient age was 27.1 years (18-51 years). The most common congenital cardiac diagnoses were: 27% with D-transposition of the great arteries (n = 27)-of which 85% (n = 23) have had a previous atrial switch procedure, 20% with tetralogy of Fallot (n = 20), and 16% with previous Rastelli repair (n = 16). Overall, 37 EP studies were performed, with the majority done in patients with complex CHD. There were 74 additional cases. These procedures consisted of: 38 pacemakers (51%), 26 implantable cardiac defibrillators (36%), six laser lead extractions (8%), two loop recorders (3%), and two pocket revisions (3%). During this 5-year period, there was one major complication (1%) and seven minor complications (7%).

Conclusions: The complex care of adults with CHD requiring EP procedures can be safely and effectively accomplished in a freestanding pediatric hospital with low complications, provided institutional support of an adult CHD program.

MeSH terms

  • Adolescent
  • Adult
  • Electrophysiologic Techniques, Cardiac / statistics & numerical data*
  • Female
  • Heart Defects, Congenital / diagnosis
  • Heart Defects, Congenital / therapy*
  • Heart Diseases / congenital*
  • Heart Diseases / diagnosis
  • Heart Diseases / therapy*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult