Cardiac arrhythmias following successful surgical closure of atrial septal defect.

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Abstract
In a series of 151 surgically treated cases of atrial septal defect, cardiac arrhythmias were encountered in 13 instances. The 2 commonest irregularities were atrial flutter and atrial fibrillation, but there was 1 instance each of supraventricular tachycardia, nodal rhythm, and heart block. A further patient had 2:1 heart block before operation but made a smooth recovery. With the exception of atrio-ventricular dissociation, the arrhythmias were not permanent, though cardioversion proved necessary on 3 occasions. The principal predisposing factors are increasing age and the presence of pulmonary arterial hypertension, as these lead to progressive hypertrophy and strain on the right heart, which in turn renders the sino-atrial node more susceptible to derangement.