Transposition of the Great Arteries

Pacing and Defibrillators in Complex Congenital Heart Disease

Device therapy is increasingly employed in the management of complex congenital heart disease (CHD). Bradycardias, most often related to sinus nodal dysfunction (SND) or atrioventricular nodal (AVN) block, may necessitate the implantation of pacing devices, while malignant arrhythmias may be treated by appropriate use of implantable cardioverter defibrillators (ICDs). However, there is a complex interplay between these classical device indications and associated supraventricular tachyarrhythmias, failure of ventricular function and ventricular dyssynchrony.

Arrhythmia in Congenital Heart Disease

Before the advent of surgery only 20% of children with congenital heart disease survived to adult life.1 Great achievements in paediatric cardiology and cardiac surgery over the last few decades resulted in an increased survival of children with congenital heart disease (CHD). Today we are facing the first generation of grown-up congenital heart disease (GUCH) patients and the management of their clinical problems represents a new complicated task for paediatricians, cardiologists, cardiac surgeons and electrophysiologists.

Essentials in the Post-operative Evaluation of Congenital Heart Disease

The last 60 years have seen significant changes in the care of congenital heart disease for both pediatric and adult patients. Increasing patient survival rates have widened the number and scope of potential patients seen by congenital cardiologists.1 These patients often undergo multiple surgeries, particularly since few lesions are truly ‘repaired.’ The majority of patients will have residua or sequelae of surgery, requiring long-term follow-up or further operations.