Dysrhythmias in patients with complete atrioventricular septal defect: From surgery to early adulthood
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Atrioventricular canal defect (AVCD) carries a wide range of myocardial electrical abnormality as part of its natural history, with total surgical correction the only means of achieving long-term survival, particularly in complete AVCD. Objective: To study the behavior of this abnormal conduction system from infancy, when repair is performed, into early adulthood the incidence of clinically significant tachy- and brady-arrhythmias, electrical remodeling, and the influence of surgical technique and syndromatic status (Down vs non-Down). Methods: This retrospective study included 100 patients who underwent total repair of a balanced complete AV canal defect at the National Heart Institute Giza and El-NAS Hospital. All underwent history taking, 12-lead surface ECG, comprehensive transthoracic 2D echocardiography, and Holter monitoring when symptomatic without documented arrhythmia on surface ECG. Results: The cohort was female-predominant (63.0%) and 66.0% had Down syndrome. Median age at repair was 9.0 months (range 5.0–42.0); the double-patch technique was used in 65 patients (65.0%) and the single-patch in 35 (35.0%). Median follow-up was 30.0 months (range 6.0–384.0). Stable sinus rhythm was maintained in 92 patients (92.0%); early post-operative arrhythmias occurred in 8.0%, comprising complete heart block requiring permanent pacing in 4 (4.0%) and junctional ectopic tachycardia in 3 (3.0%). One patient developed atrial fibrillation at 32 years. Conclusion: Despite an anatomically abnormal conduction system, patients undergoing early successful biventricular repair showed a low incidence of arrhythmogenesis into early adulthood; many demonstrated positive electrical remodeling clockwise rotation of the superior electrical axis and PR shortening though not in QRS duration or QTc.
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7204094536