Causes of Arrhythmias After Ventricular Septal Defect Closure

Arrhythmias following ventricular septal defect (VSD) closure are primarily associated with surgical procedures and the use of closure devices. Below are the key contributing factors:

Surgical Factors

During the surgical procedure, guidewires and delivery sheaths can irritate or even damage the heart tissue surrounding the conduction system, leading to arrhythmias. If the injury is minor, the arrhythmia may be transient and resolve on its own. However, in rare cases where the conduction system is significantly damaged, permanent complications such as atrioventricular (AV) block may occur, which may require long-term monitoring or further intervention.

Closure Device Related Factors

Device-induced tissue changes: The closure device can exert direct pressure or cause abrasion to the surrounding myocardial tissue. This can lead to localized edema, fibrosis, or scarring near the cardiac conduction pathways, which in turn may trigger either temporary or permanent arrhythmias.

Management of Arrhythmias

If the arrhythmia is temporary, medications such as corticosteroids may be used to reduce inflammation and improve symptoms. However, in cases of persistent or permanent arrhythmias, more aggressive treatments may be necessary. These could include removal of the closure device or the implantation of a permanent pacemaker to maintain normal heart rhythm.