Skip to main content

Electrocardiography and Cardiac Arrhythmias in Adult Congenital Heart Disease

  • Chapter
  • First Online:
Comprehensive Approach to Adult Congenital Heart Disease

Abstract

Arrhythmias make difficult the care of many adults with congenital heart disease (CHD). They are one of the leading causes of morbidity and also mortality in these patients. Their incidence and the trouble of management have made arrhythmia a reason of interest for physicians that are working in this area. In the USA, it is evaluated that there are about one million CHD patients, up to 20 % with severe disease, who need surgical intervention. The predisposing factors for arrhythmia in these patients may include aging, congenitally abnormal or displaced conduction system, abnormal hemodynamics, mechanical strain, hypoxia-induced stress, and residual or postoperative sequels. Indeed, the substrate of arrhythmia in adults with CHD is very complex. All arrhythmias that are prevalent in the normal population may also happen in CHD, and some other specific types are detected, for example, Wolff-Parkinson-White syndrome in Ebstein anomaly.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Triedman JK. Arrhythmias in adults with congenital heart disease. Heart. 2002;87(4):383–9.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–900.

    Article  PubMed  Google Scholar 

  3. Feltes TF, Friedman RA. Transesophageal echocardiographic detection of atrial thrombi in patients with nonfibrillation atrial tachyarrhythmias and congenital heart disease. J Am Coll Cardiol. 1994;24:1365–70.

    Article  CAS  PubMed  Google Scholar 

  4. Khairy P, Dore A, Talajic M, Dubuc M, Poirier N, Roy D, Mercier LA. Arrhythmias in adult congenital heart disease. Expert Rev Cardiovasc Ther. 2006;4:83–95.

    Article  PubMed  Google Scholar 

  5. Oechslin EN, Harrison DA, Connelly MS, Webb GD, Siu SC. Mode of death in adults with congenital heart disease. Am J Cardiol. 2000;86:1111–6.

    Article  CAS  PubMed  Google Scholar 

  6. Kanter RJ, Garson Jr A. Atrial arrhythmias during chronic follow-up of surgery for complex congenital heart disease. Pacing Clin Electrophysiol. 1997;20:502–11.

    Article  CAS  PubMed  Google Scholar 

  7. Duster MC, Bink-Boelkens MT, Wampler D, et al. Long-term follow-up of dysrhythmias following the Mustard procedure. Am Heart J. 1985;109:1323–6.

    Article  CAS  PubMed  Google Scholar 

  8. Vetter VL, Tanner CS, Horowitz LN. Electrophysiologic consequences of the Mustard repair of d-transposition of the great arteries. J Am Coll Cardiol. 1987;10:1265–73.

    Article  CAS  PubMed  Google Scholar 

  9. Anderson RH, Becker AE, Arnold R, Wilkinson JL. The conducting tissues in congenitally corrected transposition. Circulation. 1974;50:911–23.

    Article  CAS  PubMed  Google Scholar 

  10. Bharati S, Lev M. The conduction system in tricuspid atresia with and without regular (d-) transposition. Circulation. 1977;56:423–9.

    Article  CAS  PubMed  Google Scholar 

  11. Garson Jr A, Bink-Boelkens MTE, Hesslein PS, et al. Atrial flutter in the young: a collaborative study in 380 cases. J Am Coll Cardiol. 1985;6:871–8.

    Article  PubMed  Google Scholar 

  12. Fishberger SB, Wernovsky G, Gentles TL, et al. Factors that influence the development of atrial flutter after the Fontan operation. J Thorac Cardiovasc Surg. 1997;113:80–6.

    Article  CAS  PubMed  Google Scholar 

  13. Roos-Hesselink J, Perlroth MG, McGhie J, et al. Atrial arrhythmias in adults after repair of tetralogy of Fallot. Correlations with clinical, exercise, and echocardiographic findings. Circulation. 1995;91:221413.

    Article  Google Scholar 

  14. Khairy P, Balaji S. “Cardiac Arrhythmias In Congenital Heart Diseases” 312 early postoperative period. J Thorac Cardiovasc Surg. 2007;133:900–4.

    Article  Google Scholar 

  15. Horton RP, Canby RC, Kessler DJ, et al. Ablation of ventricular tachycardia associated with tetralogy of Fallot: demonstration of bidirectional block. J Cardiovasc Electrophysiol. 1997;8:432–5.

    Article  CAS  PubMed  Google Scholar 

  16. Murphy JG, Gersh BJ, Mair DD, et al. Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med. 1993;329:593–9.

    Article  CAS  PubMed  Google Scholar 

  17. Lucron H, Marcon F, Bosser G, et al. Induction of sustained ventricular tachycardia after surgical repair of tetralogy of Fallot. Am J Cardiol. 1999;83:1369–73.

    Article  CAS  PubMed  Google Scholar 

  18. Cullen S, Celermajer DS, Franklin RC, et al. Prognostic significance of ventricular arrhythmia after repair of tetralogy of Fallot: a 12-year prospective study. J Am Coll Cardiol. 1994;23:1151–5.

    Article  CAS  PubMed  Google Scholar 

  19. Gatzoulis MA, Till JA, Redington AN. Depolarization-repolarization inhomogeneity after repair of tetralogy of Fallot: the substrate for malignant ventricular tachycardia? Circulation. 1997;95:401–4.

    Article  CAS  PubMed  Google Scholar 

  20. Thorne SA, Barnes I, Cullinan P, Somerville J. Amiodarone-associated thyroid dysfunction: risk factors in adults with congenital heart disease. Circulation. 1999;100:149–54.

    Article  CAS  PubMed  Google Scholar 

  21. Wells R, Khairy P, Harris L, Anderson CC, Balaji S. Dofetilide for atrial arrhythmias in congenital heart disease: a multicenter study. Pacing Clin Electrophysiol. 2009;32:1313–8.

    Article  PubMed  Google Scholar 

  22. Stephenson EA, Batra AS, Knilans TK, Gow RM, Gradaus R, Balaji S, Dubin AM, Rhee EK, Ro PS, Thogersen AM, Cecchin F, Triedman JK, Walsh EP, Berul CI. A multicenter experience with novel implantable cardioverter defibrillator configurations in the pediatric and congenital heart disease population. J Cardiovasc Electrophysiol. 2006;17:41–6.

    Article  PubMed  Google Scholar 

  23. Batra AS, Balaji S. Pacing in adults with congenital heart disease. Expert Rev Cardiovasc Ther. 2006;4:663–70.

    Article  PubMed  Google Scholar 

  24. Khairy P, Landzberg MJ, Gatzoulis MA, Mercier LA, Fernandes SM, Cote JM, Lavoie JP, Fournier A, Guerra PG, Frogoudaki A, Walsh EP, Dore A. Transvenous pacing leads and systemic thromboemboli in patients with intracardiac shunts: a multicenter study. Circulation. 2006;113:2391–7.

    Article  PubMed  Google Scholar 

  25. Khairy P. Defibrillators and cardiac resynchronisation therapy in congenital heart disease. Exp Rev Med Devices. 2008;5:267–71.

    Article  Google Scholar 

  26. Stephenson EA, Casavant D, Tuzi J, Alexander ME, Law I, Serwer G, Strieper M, Walsh EP, Berul CI. Efficacy of atrial antitachycardia pacing using the Medtronic AT500 pacemaker in patients with congenital heart disease. Am J Cardiol. 2003;92:871–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Azin Alizadehasl MD, FACC .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Diz, A.A., Alizadehasl, A. (2014). Electrocardiography and Cardiac Arrhythmias in Adult Congenital Heart Disease. In: Sadeghpour, A., Kyavar, M., Alizadehasl, A. (eds) Comprehensive Approach to Adult Congenital Heart Disease. Springer, London. https://doi.org/10.1007/978-1-4471-6383-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6383-1_14

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6382-4

  • Online ISBN: 978-1-4471-6383-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics