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Arrhythmias in Congenital Heart Disease: Single Ventricle

Aya Miyazaki1, Henry Chubb2, Heather M Giacone2

  • 1Department of Adult Congenital Heart Disease, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.

Cardiac Electrophysiology Clinics
|November 8, 2025
PubMed

Insights

Arrhythmias are common in single ventricle (SV) patients due to complex heart conditions and altered hemodynamics. Effective management of bradyarrhythmias and tachyarrhythmias is crucial for improving SV patient outcomes.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Electrophysiology

Background:

  • Single ventricle (SV) physiology presents unique challenges due to anatomical and surgical heterogeneity.
  • Arrhythmias in SV patients stem from congenital factors, ischemic injury, fibrosis, and myocardial stretch.
  • Arrhythmias significantly contribute to morbidity and mortality in SV patients, potentially indicating heart failure progression.

Purpose of the Study:

  • To highlight the critical role of arrhythmias in single ventricle patient outcomes.
  • To emphasize the importance of comprehensive arrhythmia management in SV physiology.

Main Methods:

  • Review of existing literature on arrhythmogenesis in single ventricle patients.
  • Analysis of the impact of arrhythmias on hemodynamic status and heart failure.
  • Discussion of acute and long-term management strategies for bradyarrhythmias and tachyarrhythmias.

Main Results:

  • Arrhythmias are a major cause of morbidity and mortality in single ventricle patients.
  • The presence of arrhythmias can be both a cause of heart failure and a sign of deteriorating SV physiology.
  • Effective management of arrhythmias is essential for optimizing hemodynamic profiles.

Conclusions:

  • Optimizing hemodynamic status in single ventricle patients necessitates appropriate management of both bradyarrhythmias and tachyarrhythmias.
  • Proactive and comprehensive arrhythmia control is critical for improving long-term outcomes in single ventricle physiology.

Keywords:
ArrhythmiaCardiac resynchronizationFontanPacemakerSingle ventricle

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