The Single Center Experience of Pacing Device Implantation in Patients with Complex Congenital Heart Disease

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概要

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• <B>Aim:</B> Transvenous cardiovascular implantable electronic devices (CIEDs) implantation in patients with complex congenital heart disease (CCHD) is challenging because of their complex anatomy. We report our experience of CIEDs implantation in CCHD patients. <B>Methods:</B> CCHD patients underwent the CIEDs implantation, were analyzed retrospectively. <B>Results:</B> We implanted CIEDs (pacemaker n=19, ICD n=5, CRT-D n=2) in consecutive 26 CCHD patients (mean 25 y.o.) from 1994 to 2011. The underlying heart diseases were tricuspid atresia (n=2) and single RV (n=1) both after Fontan operation, single LV (n=1) underwent the septation, truncus arteiosus communis underwent Rastelli (n=1), transposition of great ateries (TGA) (n=9) and corrected TGA (n=12; SLL n=9, IDD n=3). Twelve patients with TGA and corrected TGA underwent atrial switch (n=6) or double switch (n=6) operation. The pacing leads were successfully positioned with favorable sensing and pacing threshold in all patients, transvenously, without major complications. In 2 patients with cTGA, we successfully positioned the leads at the LV apex and in the coronary vein for the resynchronization of anatomical RV. The lead revision was required during the follow-up period, due to the lead dislodgement (n=2) and the lead fracture (n=2). <B>Conclusion:</B> Transvenous implantation of CIEDs was safely performed and feasible even in patients with CCHD and sometimes with atrio-ventricular discordance.

著者

• Yagishita Daigo

  Department Of Cardiology Osaka City General Hospital

• Ejima Koichiro

  Department Of Cardiology Tokyo Women's Medical University

• Takeuchi Daiji

  Department Of Pediatric Cardiology Tokyo Women's Medical University

• Yashiro Bun

  Department Of Cardiology Tokyo Women's Medical University

• Shoda Morio

  Department Of Cardiology The Cardiovascular Center Of Sendai

• Hagiwara Nobuhisa

  Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical University

• Manaka Tetsuyuki

  Department Of Cardiology Tokyo Women's Medical University

• Wakisaka Osamu

  Department Of Internal Medicine 1 Faculty Of Medicine Oita Univercity

• Takeuchi Daiji

  Department of Pediatric Cardiology, Tokyo Women's Medical University

• Toyohara Keiko

  Department of Pediatric Cardiology, Tokyo Women's Medical University

• Wakisaka Osamu

  Department of Cardiology, Tokyo Women's Medical University

• Toyohara Keiko

  Department of Pediatric Cardiology, Tokyo Women's Medical University

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