Congenital heart disease (CHD), pregnancy and cardiac devices

If you have a congenital heart disease (CHD), you may need a pacemaker or an ICD. The reason for this may be the heart disease itself and/or the therapies you received, including surgical corrections. In case of CHD, the implantation of the devices is made more complex because of the anatomical particularities. Mainly, the access to the heart via the vessels may be different than in the patients with no CHD and there may be a communication of the blood circulation between the right heart chambers and the left heart chambers. In addition, CHD patients are often required to have a device implanted for a long period of their life. All of this must be taken into consideration by your doctors. This is not always the case, but sometimes, due to the above particularities, a surgical approach is used for implantation, i.e. the lead(s) are not introduced through the vessels but sutured on the surface of the heart muscle at the level of the atria or ventricles by surgery. For all these reasons, it is most often a team including congenital heart disease specialists and defibrillation/pacing specialists who will make the decisions about implantation and follow-up of your device. Technically, device monitoring and follow-up is the same as in patients without CHD.

In the event of pregnancy, there are no special precautions related to the presence of a pacemaker or a defibrillator. There is no interference between the operation of the device or its interrogation and the fetus. However, a patient with a pacemaker or an ICD may have a concomitant heart disease, and pregnancy is a situation during which heart diseases, when present, have to be monitored more closely.