- 作者：Petra Opi? ; Matthijs van Kranenburg ; Sing-Chien Yap ; Arie P. van Dijk ; Werner Budts ; Hubert W. Vliegen ; Lieselot van Erven ; Anil Can ; Gulhan Sahin ; Dominic A.M.J. Theuns ; Maarten Witsenburg ; Jolien W. Roos-Hesselink
- 关键词：Congenital heart disease ; Pacemaker ; Complication ; Tetralogy of Fallot ; Transposition of the great arteries ; Lead failure
- 刊名：International Journal of Cardiology
- 出版年：2013
- 出版时间：9 October, 2013
- 年：2013
- 卷：168
- 期：4
- 页码：3212-3216
- 全文大小：297 K
Background
This study aims to investigate indications and complications of permanent cardiac pacing in adults with congenital heart disease (CHD).Methods and results
Two-hundred and seventy-four CHD patients were identified who underwent permanent pacemaker implantation between 1972 and 2009. The indication for pacing was acquired sinus node or AV node conduction disease (63 % ), sinus node or AV node conduction disease after cardiac surgery (28 % ), and drug/arrhythmia-related indications (9 % ). Patients with complex CHD received a pacemaker at younger age (23 versus 31 years, p < 0.0001) and more often received an epicardial pacing system (51 % versus 23 % , p < 0.0001) compared to those with simple or moderate CHD. Twenty-nine patients (10.6 % ) had a periprocedural complication during the primary pacemaker implantation (general population: 5.2 % ). The most common acute complications were lead dysfunction (4.0 % ), bleeding (2.6 % ), pocket infection (1.5 % ) and pneumothorax (1.5 % ). During a median follow-up of 12 years, pacemaker-related complications requiring intervention occurred in 95 patients (34.6 % ). The most common late pacemaker-related complications included lead failure (24.8 % ), pacemaker dysfunction/early battery depletion (5.1 % ), pacemaker migration (4.7 % ) and erosion (4.7 % ). Pacemaker implantation at younger age (< 18 years) was an independent predictor of late pacemaker-related complication (adjusted hazard ratio 1.68, 95 % confidence interval 1.07 to 2.63, p = 0.023).
Conclusions
The risk of periprocedural complications seems higher in the CHD population compared to the general population and more than one-third of CHD patients encountered a pacemaker-related complication during long-term follow-up. This risk increases for those who receive a pacemaker at younger age.