Recognition and management of arrhythmias in adult congenital heart disease

PURPOSE OF REVIEW: Adults with congenital heart disease now outnumber children with these syndromes in developed countries. This has seen a surge in the care required for these patients, and the development of an entirely new realm of cardiology. Arrhythmia is one of the most common causes of morbidity and mortality in this group, and this review highlights current approaches to recognition and management. RECENT FINDINGS: Atrial arrhythmias are especially common in this group of patients, while pacemaker or implantable cardioverter defibrillator implantation and cardiac ablation are also frequently necessary. The presentation and management of these entities present salient differences for the clinician--for both acute and chronic care--and more recently a national societal consensus statement has attempted to encapsulate the best approach. Without any level of evidence A, all recommendations are based on data derived from nonrandomized studies or only expert/consensus opinion. This review is aimed at providing current opinion on optimum clinical care in this arena in lieu of this publication and the more novel corroborative clinical studies. SUMMARY: Recognition and appropriate management of arrhythmia in adults with congenital heart disease frequently differ from those patients with a normal heart or acquired heart disease. Early diagnosis and proper treatment are essential in this complex patient category.