Arrhythmia is one of the most common and serious complications of adult congenital heart disease (ACHD). Surgical scars, abnormal heart anatomy, volume or pressure overload, and aging all contribute to abnormal electrical activity. Intra-atrial reentrant tachycardia (IART), atrial fibrillation, atrial flutter, ventricular tachycardia, and heart block are all seen with increased frequency in adults with CHD compared to the general population.
Common Arrhythmias in ACHD
Types of arrhythmia frequently encountered in ACHD include:
- Intra-atrial reentrant tachycardia (IART) — especially after Fontan, Mustard, or Senning procedures.
- Atrial fibrillation and atrial flutter — common with volume-loaded ventricles and aging.
- Ventricular tachycardia — seen in repaired tetralogy of Fallot and other conotruncal defects.
- Sinus node dysfunction and heart block — may require pacemaker implantation.
- Wolff–Parkinson–White (WPW) syndrome — associated with Ebstein anomaly.
Have questions about your care?
Speak directly with our team — no referral needed for most consultations.
Management of arrhythmia in ACHD requires expertise in both electrophysiology and congenital heart anatomy. Options may include antiarrhythmic medications, catheter ablation (often performed at specialized ACHD centers), device therapy (pacemakers or ICDs), and anticoagulation. Congenital Heart Compass Medical PLLC evaluates and co-manages arrhythmia in ACHD patients across New York, coordinating with electrophysiology colleagues at regional centers when procedures are needed.
Reviewed by Dr. Pradeepkumar Charla, MD, MBA, FAAP, FACC
Pediatric & Adult Congenital Cardiologist — Congenital Heart Compass Medical PLLC
Last reviewed:
Medical disclaimer: This content is for educational purposes only and is not a substitute for individualized medical advice, diagnosis, or treatment. Always consult a qualified cardiologist for decisions about your congenital heart disease care.