Innovations in surgical and medical treatment continue to improve the outlook for children with complex congenital heart disease. Although mortality continues to decrease, disease-related morbidity is increasing as a large cohort of these patients is reaching young adulthood, pursuing careers, marrying, and in many cases having children of their own. Chronic recurrent dysrhythmias are a frequent cause of long-term morbidity in this population and result in frequent, unanticipated emergency room visits and hospitalizations. Although not usually life threatening, they can pose considerable challenges to the patients and the providers who care for them. This article provides an overview of the most common dysrhythmias encountered in this population, dysrhythmia substrates, and therapeutic options.

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