Abstract
Survival of children with congenital heart disease (CHD) continues to improve in lockstep with advances in surgical and medical therapy, and more than 90% now reach adulthood. Despite the impressive anatomic repairs that are now achievable, even adults with fully repaired CHD cannot be regarded as having normal hearts, and many will be prone to arrhythmias.
More and more will meet indications for implantable cardiac devices-pacemakers as definitive therapy for bradycardia, implantable cardioverter-defibrillators (ICDs) for ventricu-lar arrhythmias, and cardiac resynchronization devices for impaired myocardial function and dyssynchrony. However, device implantation in adults with CHD is fraught with unique technical and management challenges, as described in this chapter