Does Congenital Heart Disease Cause Arrhythmias

June 14, 2023

female doctor using stethoscope to examine woman

Taking care of your health is always important, especially when you’re born with a heart defect (congenital heart disease). Having a heart defect makes other health problems more likely. Arrhythmia, an irregular heartbeat, is a serious concern for those with adult congenital heart disease (ACHD).

Most arrhythmias aren’t fatal, but they can cause symptoms like heart palpitations, a rapid heart rate and fatigue. The bigger problem? They double your risk of stroke and they’re the leading cause of hospitalizations for those with ACHD. Screening for and treating arrhythmias is essential for staying healthy.

Cardiac Arrhythmia Due to Congenital Heart Disease

Developing an arrhythmia when you have ACHD isn’t inevitable. But you’re much more susceptible to it than someone without a heart defect. One large study found that 15 percent of adult participants with ACHD also had atrial arrhythmias, the most common irregular heartbeat associated with the condition. More than half of those with severe ACHD developed an arrhythmia by the time they turned 65.

How does congenital heart disease cause arrhythmia?

Both congenital heart disease and surgery to correct defects make you prone to arrhythmias. Here’s why: An electrical signal moves from the top to the bottom of the heart to make it contract (squeeze). That creates your heartbeat, which pushes blood out to the rest of the body.

In ACHD, arrhythmias usually occur because something interferes with the movement of the electrical impulse through the heart. The causes could include:

  • Abnormal structure of the heart or surrounding blood vessels
  • Prosthetic patches (synthetic material) from heart repair
  • Surgical scar tissue
  • Thickening of heart tissue

“Your risk of developing an arrhythmia is based largely on the type of heart defect you have and the surgery, which leaves a scar in a specific location in your heart. Based on that, we can often tell what type of arrhythmia is likely,” says Daniel Benhayon Lanes, MD, an electrophysiologist (EP) at Memorial Cardiac and Vascular Institute.

Common Congenital Arrhythmias

ACHD is typically associated with certain types of arrhythmias, including:

  • Atrial flutter: This type of arrhythmia occurs when the upper chambers of the heart (atria) contract too fast and get out of sync with the lower chambers.
  • Atrial fibrillation (AFib): With AFib, the upper chambers quiver instead of contract, which causes an irregular rhythm. AFib is the most common arrhythmia in people over 65 with ACHD.
  • Intra-atrial reentry tachycardia (IART): IART triggers episodes of a rapid heartbeat that stem from an unusual place in the heart’s upper chambers. This type of arrhythmia is most common in people under 50 with ACHD. IART can gradually progress to AFib.

What triggers arrhythmias?

Arrhythmias can develop immediately following surgery or occur years or decades later. Besides surgery, multiple factors can trigger arrhythmias, including:

  • Excessive alcohol use
  • High blood pressure
  • Infections
  • Weight gain

Arrhythmia Management

Having an arrhythmia when you have ACHD is concerning because it can lead to a stroke. An irregular heartbeat may allow blood to pool in the heart and clot. When a clot breaks free, it circulates through blood vessels and can lodge in one that leads to the brain.

A stroke occurs when a clot obstructs blood flow (and oxygen) to the brain. To reduce the risk of stroke from arrhythmia, it’s essential to screen for arrhythmias and treat them.

Cardiologists use several tests and procedures to diagnose arrhythmias. Your cardiologist may recommend testing for arrhythmia if you’re having symptoms such as:

  • Dizziness
  • Fatigue
  • Feeling like your heart is beating in your throat
  • Fluttering or pounding in your chest
  • Racing heart rate

Seek immediate medical attention if you experience emergency symptoms:

  • Chest pain or pressure
  • Fainting
  • Shortness of breath


Arrhythmia treatment minimizes stroke risk and regulates your heart’s rhythm. Common treatments include:

  • Blood thinners: These medications reduce your stroke risk by preventing your blood from clotting.
  • Medications: Drugs that control heart rate or change the rhythm help get your heartbeat back on track.
  • Electrical cardioversion: If your heart is in a constant arrhythmia, you may need this medical procedure. It delivers a small electrical shock to your heart to reset its rhythm.
  • Catheter ablation: During this minimally invasive procedure, the doctor weaves a thin, hollow tube (catheter) through a blood vessel to your heart. Then they deliver heat or cold energy through the catheter to destroy the heart tissue causing the arrhythmia.

Schedule an Appointment for Heart and Vascular Services

When you have ACHD, the program and team you choose to care for your heart can make a big difference. Learn more about ACHD treatments and services at Memorial Cardiac and Vascular Institute. To schedule an appointment with a cardiologist, electrophysiologist or vascular specialist at Memorial, call 855-400-6284.