Implantable defibrillators: from the adult cardiac to the grown up congenital heart disease patient

The automatic implantable defibrillators (AID) are increasingly used for both secondary and primary prevention of sudden cardiac death (SCD) in high risk adult cardiac patients with sustained ventricular arrhythmias (SVA) and/or significant ventricular dysfunction. The corresponding experience with AIDs in pediatric and young adult population is limited suggesting at least the same benefit as in the adult population. With the growing number of adults with previous corrective surgery of complex congenital heart disease (CHD), a need to address the risk stratification process for SCD among these patients is becoming increasingly important. For the present time, the AIDs have been mostly utilized for the secondary prevention of SCD in those postoperative CHD adult patients with a history of SVA. Currently available data on how to assess the risk for SCD among such patients as well as implications about the potential to prevent SCD with an earlier use of AID in this growing population are presented and discussed.