{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T05:50:14Z","timestamp":1769925014906,"version":"3.49.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The value of implantable cardioverter defibrillators (ICDs) in adults with congenital heart disease (CHD) is unknown. We investigated the long-term outcome after ICD implantation and developed a simple risk stratification score for ICD therapy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              A total of 136 adults with CHD and ICD (mean age\u00b1SD, 41\u00b113 years; 67% male) were identified from 10 tertiary referral centers in the Netherlands and Belgium. The indication for ICD implantation was primary prevention in 50% of patients. Diagnoses included tetralogy of Fallot (51%), septal defects (20%), (congenitally corrected) transposition of the great arteries (13%), and other (16%). Thirty-nine patients (29%) received appropriate ICD shocks during a median follow-up of 4.6 years. Secondary prevention indication (hazard ratio [HR], 3.6; 95% CI, 1.3\u20139.5;\n              <jats:italic>P=<\/jats:italic>\n              0.009), coronary artery disease (HR, 2.7; 95% CI, 1.0\u20137.2;\n              <jats:italic>P=<\/jats:italic>\n              0.042), and symptomatic nonsustained ventricular tachycardia (NSVT; HR, 9.1; 95% CI, 2.8\u201329.2;\n              <jats:italic>P=<\/jats:italic>\n              0.001) were associated with appropriate ICD shocks. A risk score was developed to evaluate the likelihood of appropriate ICD shocks. The 8-year survival curve to first appropriate shocks was 94%, 57%, and 26% for low-, intermediate-, and high-risk patients, respectively. In primary prevention, symptomatic NSVTs (HR, 8.0; 95% CI, 2.3\u201327.1;\n              <jats:italic>P=<\/jats:italic>\n              0.001) and subpulmonary ventricular dysfunction (HR, 3.0; 95% CI, 1.2\u201312.6;\n              <jats:italic>P<\/jats:italic>\n              =0.02) were associated with appropriate shocks in univariable analysis. Inappropriate shocks occurred in 41 patients (30%). In addition, 40 patients (29%) experienced 45 implantation-related complications.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Adults with CHD and ICDs receive high rates of appropriate and effective shocks. Patients with secondary prevention indication, coronary artery disease, and symptomatic NSVT are at highest risk of receiving appropriate ICD shocks. ICD implantation is accompanied by considerable morbidity, including inappropriate shocks and procedure- related complications.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.111.966754","type":"journal-article","created":{"date-parts":[[2011,11,18]],"date-time":"2011-11-18T05:54:53Z","timestamp":1321595693000},"page":"101-110","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":79,"title":["Implantable Cardioverter Defibrillator Therapy in Adults With Congenital Heart Disease"],"prefix":"10.1161","volume":"5","author":[{"given":"Zeliha","family":"Koyak","sequence":"first","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joris R.","family":"de Groot","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle C.","family":"Van Gelder","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Berto J.","family":"Bouma","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pascal F.H.M.","family":"van Dessel","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Werner","family":"Budts","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lieselot","family":"van Erven","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie P.J.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur A.M.","family":"Wilde","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petronella G.","family":"Pieper","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gertjan T.","family":"Sieswerda","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara J.M.","family":"Mulder","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology (Z.K., J.R.d.G., B.J.B., P.F.H.M.v.D., A.A.M.W., B.J.M.M.), Academic Medical Center Amsterdam, Amsterdam, The Netherlands; the Department of Cardiology (I.C.V.G., P.G.P.), University Medical Center Groningen, Groningen, The Netherlands; the Department of Cardiology (W.B.), University Hospitals Leuven, Leuven, Belgium; the Department of Cardiology (L.v.E.), Leiden University Medical Center, Leiden, The Netherlands; the Department of Cardiology (A.P.J.v.D.),..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01169-3"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq032"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.05.040"},{"key":"e_1_3_2_5_2","article-title":"Circumstances of death in adult congenital heart disease","author":"Zomer AC","year":"2010","unstructured":"Zomer AC, Vaartjes I, Uiterwaal CS, van der Velde ET, van den Merkhof LF, Baur LH, Ansink TJ, Cozijnsen L, Pieper PG, Meijboom FJ, Grobbee DE, Mulder BJ . 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