Late Complete Heart Block after Surgical Repair of an Atrial Septal Defect

ABSTRACT Atrial septal defects (ASD) are among the most common forms of congenital heart disease. Although surgical correction was the only available therapy for decades, its long-term complications remain unknown and many patients do not have structured medical follow-up in later life. However, increasing evidences suggest that late-onset cardiac problems, such as complete heart block (CHB), can arise after surgery and therefore, long-term follow-up should be advised in these patients. We hereby present an interesting case of CHB occurring in a 30-year-old patient who had undergone surgical secundum ASD closure approximately 21 years prior to this event and now presented with episodes of dizziness and pre-syncope. Seven-day Holter reported seven episodes of CHB, corresponding to the presenting complaints. The patient was successfully managed with conduction system pacing and he remained asymptomatic on further follow-up. The case description is followed by a brief overview of the available literature.