Occurrence and outcome of arrhythmia related to interventional therapy for perimembranous ventricular septal defect

  AIM  To explore the occurrence and the outcome of arrhythmia related to interventional therapy for ventricular septal defect (VSD).

  METHODS  VSD patients who were successfully treated with interventional therapy in our hospital and had complete follow-up data from October 2002 to May 2019 were selected as the research subjects. ECG and Holter data of the patients during the preoperative and postoperative follow-up period (1, 3, 6, 12 months respectively, followed up once a year) were counted. The occurrence and the outcome of VSD intervention related arrhythmia were analyzed.

  RESULTS  A total of 1125 VSD patients undergoing interventional therapy in our hospital were selected and 794 patients (424 males and 370 females) with perimembranous VSD were included for analysis. All patients were followed up for more than one year and the average follow-up time was (12.45 ± 4.70). The results showed that: Thirteen cases (1.64%) had arrhythmia before VSD interventional occlusion, including 3 cases of frequent atrial premature beat with short atrial tachycardia, 4 cases of ventricular premature beat and 6 cases of complete right bundle branch block (CRBBB). Eighty six patients (10.83%) had new arrhythmias during VSD occlusion and follow-up, including 17 cases (2.14%) of CRBBB, 20 cases (2.52%) of incomplete right bundle branch block (IRBBB), 17 cases (2.14%) of complete left bundle branch block (CLBBB), 4 cases (0.5%) of first degree atrioventricular block (AVB), 12 cases (1.51%) of third degree AVB, 10 cases (1.26%) of ventricular arrhythmia and 6 cases (0.76%) of supraventricular arrhythmia. Eighty-four cases of new arrhythmia occurred during and after VSD interventional therapy, of whom 74 cases (88.1%) recovered completely after treatment and 92.9% of whom returned to normal at 1 month follow-up. During the long-term follow-up, there were 1 case of CLBBB and 1 case of third degree AVB. Permanent pacemaker was implanted in the third degree AVB patient.

  CONCLUSION  The incidence of perimembranous VSD intervention related arrhythmias is high, but most of which can completely return to normal after active treatment. Severe arrhythmia can still occur long after VSD interventional therapy, which should attract clinical attention.