Electrophysiology Procedures in Adults with Congenital Heart Disease.
Summary of "Electrophysiology Procedures in Adults with Congenital Heart Disease."
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.
Affiliation
Department of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Tex, USA.
Journal Details
This article was published in the following journal.
Name: Congenital heart disease
ISSN: 1747-0803
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22536993
- DOI: http://dx.doi.org/10.1111/j.1747-0803.2012.00658.x
Medical and Biotech [MESH] Definitions
Endocardial Fibroelastosis
A condition characterized by the thickening of ENDOCARDIUM due to proliferation of fibrous and elastic tissue, usually in the left ventricle leading to impaired cardiac function (CARDIOMYOPATHY, RESTRICTIVE). It is most commonly seen in young children and rarely in adults. It is often associated with congenital heart anomalies (HEART DEFECTS CONGENITAL;) INFECTION; or gene mutation. Defects in the tafazzin protein, encoded by TAZ gene, result in a form of autosomal dominant familial endocardial fibroelastosis.
Cardiac Electrophysiology
The study of the electrical activity and characteristics of the HEART; MYOCARDIUM; and CARDIOMYOCYTES.
Norwood Procedures
A set of surgical procedures performed to establish sufficient outflow to the systemic circulation in individuals with univentricular congenital heart malformations, such as HYPOPLASTIC LEFT HEART SYNDROME, and MITRAL VALVE atresia, associated with systemic outflow obstruction. Follow-on surgeries may be performed and consist of a HEMI-FONTAN PROCEDURE as the stage 2 Norwood procedure and a FONTAN PROCEDURE as the stage 3 Norwood procedure.
Rheumatic Heart Disease
Cardiac manifestation of systemic rheumatological conditions, such as RHEUMATIC FEVER. Rheumatic heart disease can involve any part the heart, most often the HEART VALVES and the ENDOCARDIUM.
Ventricular Outflow Obstruction
Occlusion of the outflow tract in either the LEFT VENTRICLE or the RIGHT VENTRICLE of the heart. This may result from CONGENITAL HEART DEFECTS, predisposing heart diseases, complications of surgery, or HEART NEOPLASMS.
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