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Beyond symptoms: Rhythm surveillance in congenital heart disease

Ying-Lun Hsu1, Wei-Chieh Tseng2, Yen-Teng Hsu3

  • 1Department of Pediatrics, College of Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan.

Heart Rhythm O2
|June 29, 2026
PubMed

Insights

Seven-day monitoring detects more arrhythmias in congenital heart disease (CHD) patients than shorter methods. Prolonged surveillance improves detection and management, regardless of symptoms, and is guided by age and disease complexity.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Patients with congenital heart disease (CHD) have a lifelong risk of developing arrhythmias.
  • Many of these arrhythmias are asymptomatic and go undetected, posing a significant health risk.

Purpose of the Study:

  • To evaluate the diagnostic yield of various rhythm surveillance strategies in CHD patients.
  • To assess the correlation between symptoms and arrhythmias.
  • To determine the clinical value of arrhythmia screening in this population.

Main Methods:

  • A retrospective analysis of 552 CHD patients undergoing 7-day patch rhythm monitoring.
  • Patients were categorized into symptomatic and asymptomatic (screening) groups.
  • Comparison of detection rates between 7-day patch monitoring, Holter, and event recorders.

Main Results:

  • 7-day monitoring detected arrhythmias in 66.1% of patients, significantly higher than Holter (46.9%) or event recorders (17.3%).
  • Arrhythmia prevalence increased with CHD complexity and age, exceeding 15% in the fourth decade.
  • Symptom-arrhythmia correlation was weak, particularly in symptomatic patients.

Conclusions:

  • Arrhythmias are common, age-dependent, and poorly predicted by symptoms in CHD.
  • Prolonged monitoring (7-day patch) enhances arrhythmia detection and aids management decisions.
  • Risk-stratified surveillance based on age and CHD complexity is recommended.
Abstract

Keywords:
Ambulatory ECG monitoringArrhythmia detectionAsymptomatic arrhythmiaCongenital heart diseaseExtended rhythm monitoring

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