Congenital cardiac patients have benefitted from the advent and refinement of corrective and palliative cardiac surgery and echocardiography. Electrophysiological studies, curative ablations, pacemakers, and defibrillators have led to the increased longevity in those who have had the burden of dysrhythmias in their de novo and post-operative care. These improvements have led to the increasing emphasis on the care of a rapidly growing population of adolescents and adults with congenital heart disease. The emphases on those with arrhythmias are usually with congenital lesions such as post-operative Tetralogy of Fallot, transposition of the great arteries after the Mustard and Senning operations, for isomerism, corrected transposition, and post-Ross procedure. The index case is a 36-year-old female with de novo congenital restrictive perimembranous ventricular septal defect who developed cardiac decompensating ventricular fibrillation and atrial flutter, who had no other predisposing factor for dysrhythmia. A rare case documented after an extensive search in the English Medical Literature.
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