Abstract: Perimembranous ventricular septal defects (pmVSDs) are the most common congenital heart disease. Since the early 2000 s, Amplatzer pmVSD occluder (AGA Medical, Golden Valley, MN, USA) has been widely used in transcatheter procedures for closure of pmVSDs. Recently, clinical trials with modified Amplatzer occluder and other new devices have demonstrated promising results in initial studies. Unfortunately, many medical centers have abandoned the first-generation Amplatzer pmVSD occluders due to their unacceptably high risk of postprocedural and late-onset complete atrioventricular block (cAVB). However, study of the mechanism of cAVB and further optimal selection of occluders will provide a new approach for application of Amplatzer occluders in transcatheter closure of pmVSDs.