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Background: Population based studies show a steady increase in adult patients with congenital heart defects. The aim of this study was to assess the evolution of such a patient cohort and its burden on clinical care at a dedicated tertiary care centre., Methods: All patients with congenital heart disease followed up by a dedicated multidisciplinary team at our institution were identified (n = 1725). Disease characteristics, the increase in patient numbers and interventions and the increase in selected complications were analysed and compared between the first (1996-2005) and second (2006-2015) decades of the study period., Results: Between the two decades of the study period, the number of patients in follow-up increased by 109%, the number of patients who died or underwent transplantation more than doubled and the number of outpatient visits increased by 195%. One fourth of all patients underwent at least one surgical procedure and 14% had at least one percutaneous intervention. The increase in surgical procedures between the two decades was 27% and the increase in percutaneous interventions 159%. Between the two decades the number of patients requiring direct current cardioversion increased from 32 to 95 (+197%), the number of patients requiring admission for infective endocarditis increased from 7 to 29 (+314%) and the number of women followed up during pregnancy increased from 18 to 115 (+539%)., Conclusion: As a result of the increasing number and complexity of adult survivors with congenital heart disease more resources will be needed to cope with the demands of this novel cohort of complex patients in adult cardiology.

Background: Catheter ablation is an effective and safe treatment for various arrhythmic disorders. Patients are frequently admitted for an overnight stay after the ablation procedure to monitor for possible postprocedural complications or recurrence of the arrhythmia. The aim of this study was to assess patient satisfaction in patients with supraventricular tachycardia following catheter ablation on an outpatient basis., Methods: 243 consecutive patients (129 male, 53%; mean age 49 +/- 17 years) underwent electrophysiological study and radiofrequency catheter ablation either on an outpatient basis or a hospitalisation that included at least an overnight hospital stay (inpatient) at a university hospital. All patients were asked to complete a specially designed questionnaire that addressed patient satisfaction as well as the clinical outcome after ablation at six months., Results: The ablation procedure was performed on an outpatient basis in 119 patients (49%). The long-term procedural success rate was 99%. The overall patient satisfaction with the ablation procedure and with the clinical outcome at six months was 90%. There were no significant differences between outpatient and inpatient groups with respect to ablation results and patient satisfaction. Patients in the outpatient group returned to work after 2.8 +/- 1.9 days as compared to 3.9 +/- 2.2 days in the in hospital group (p = 0.001)., Conclusion: Overall patient satisfaction and self-reported clinical outcome are comparable for outpatient and inpatient catheter ablations. Patients undergoing outpatient procedures may return to work earlier. Therefore, outpatient ablation procedures may be considered for selected patients without significant comorbidities.