Practical aspects of implantable defibrillator therapy in patients with congenital heart disease.

Improved awareness of the risk for malignant ventricular arrhythmias in patients with congenital heart disease (CHD), together with dramatic advances in implantable cardioverter-defibrillator (ICD) technology, have led to a rapid increase in device therapy for this population. Clinical challenges remain surrounding patient selection and difficulties with lead positioning that arise in response to the anatomic and physiologic complexities of CHD. This article will attempt to review contemporary data on ICD use in the CHD population with particular attention to the novel implant methodology required for many of these patients.