Postoperative tachyarrhythmias are a major cause of morbidity in congenital heart disease patients, requiring tailored management including pharmacological therapy, ablation, and device therapy.
This review provides a comprehensive overview of the mechanisms, risk factors, and management strategies for early and late postoperative tachyarrhythmias in the growing population of children and young adults with congenital heart disease.
The population of patients with congenital heart disease is constantly growing with an increasing number of individuals reaching adulthood. A significant proportion of these children and young adults will suffer from tachyarrhythmias due to the abnormal anatomy, the hemodynamic burden, or as a sequela of surgical treatment. Depending on the underlying mechanism, arrhythmias may arise in the early postoperative period (hours to days after surgery) or in the late postoperative period (usually years after surgery). A good understanding of the electrophysiological characteristics and pathophysiological mechanisms is therefore crucial to guide the therapeutic approach. Here, we synthesize the current state of knowledge on epidemiological features, risk factors, pathophysiological insights, electrophysiological features, and therapy regarding tachyarrhythmias in children and young adults undergoing reparative surgery for congenital heart disease. The evolution and latest data on treatment options, including pharmacological therapy, ablation procedures, device therapy decision, and thromboprophylaxis, are summarized. Finally, throughout this comprehensive review, knowledge gaps and areas for future research are also identified.
Joye et al. (Wed,) conducted a review in Postoperative tachyarrhythmias in congenital heart disease. Postoperative tachyarrhythmias are a major cause of morbidity in congenital heart disease patients, requiring tailored management including pharmacological therapy, ablation, and device therapy.