Arrhythmia diagnosis and management throughout life in congenital heart disease

Bradley C. Clark, Charles I. Berul

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations


Arrhythmias, covering bradycardia and tachycardia, occur in association with congenital heart disease (CHD) and as a consequence of surgical repair. Symptomatic bradycardia can occur due to sinus node dysfunction or atrioventricular block secondary to either unrepaired CHD or surgical repair in the area of the conduction system. Tachyarrhythmias are common in repaired CHD due to scar formation, chamber distension or increased chamber pressure, all potentially leading to abnormal automaticity and heterogeneous conduction properties as a substrate for re-entry. Atrial arrhythmias occur more frequently, but ventricular tachyarrhythmias may be associated with an increased risk of sudden cardiac death, notably in patients with repaired tetralogy of Fallot or aortic stenosis. Defibrillator implantation provides life-saving electrical therapy for hemodynamically unstable arrhythmias. Ablation procedures with 3D electroanatomic mapping technology offer a viable alternative to pharmacologic or device therapy. Advances in electrophysiology have allowed for successful management of arrhythmias in patients with congenital heart disease.

Original languageEnglish (US)
Pages (from-to)301-320
Number of pages20
JournalExpert Review of Cardiovascular Therapy
Issue number3
StatePublished - Mar 3 2016
Externally publishedYes


  • Arrhythmia
  • ablation
  • bradycardia
  • congenital heart disease
  • electrophysiology study
  • implantable cardioverter defibrillator
  • pacemaker
  • tachycardia

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine


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