Presentation Information
[II-AEPCJS-3]Lifelong Management of CIEDs in Congenital Heart Disease: Lead Strategy and Device Planning
○Yoshiaki Kato, Tohru Iwasa, Kazuto Fujimoto, Takako Toda, Yuuki Ito, Yoshihito Morimoto, Yuri Murayama, Naoki Iida, Hideo Ohuchi, Kenichi Kurosaki (National Cerebral and Cardiovascular Center)
Keywords:
cardiac implantable electronic devices,congenital heart disease,lifelong management
Cardiac implantable electronic devices (CIEDs) play an increasing role in the management of congenital heart disease (CHD), but lifelong device management remains challenging. Lead and generator selection must account not only for current anatomy and arrhythmia substrate, but also for future venous access, surgical options, and the likelihood of repeated reintervention. Management strategy must therefore evolve over time, particularly when deciding whether to retain epicardial systems or when transvenous implantation becomes feasible. In patients with limited venous access or complex postsurgical anatomy, epicardial leads may remain the most practical long-term option, making long-term device planning a central issue. Although new device technologies may broaden treatment options, their impact on lifelong management remains uncertain because use is constrained by anatomical heterogeneity, durability and extraction issues, and the need for center-specific expertise. In Japan, beyond these shared challenges, strengthening the transition from pediatric to adult care and sustaining multidisciplinary collaboration across pediatric cardiology, ACHD, electrophysiology, and congenital cardiac surgery remain important issues. This presentation outlines a practical framework for lifelong CIED management in CHD, emphasizing lead strategy, long-term device planning, and continuity of care in Japan.