日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Arrhythmias are common complications in adults with congenital heart disease that might cause sudden cardiac death. Arrhythmias vary according to factors such as underlying heart disease and the methods of surgical repair, and they increase in prevalence with age. Therapeutic strategies differ with the complexity of underlying heart disease and hemodynamic status. Pacemaker implantation is indicated for patients with symptomatic bradyarrhythmias caused by either sinus node dysfunction or atrioventricular block. In patients with atrial flutter and fibrillation, anticoagulation therapy is important for preventing cardiogenic embolism. Various antiarrhythmic agents are used, and catheter ablation may be effective. In ventricular tachycardia, both pharmacologic and non-pharmacologic therapies are needed. Implantable cardioverter defibrillators represent the primary modality for preventing sudden cardiac death, and antiarrhythmic agents and catheter ablation are indicated as adjunctive therapies.