{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T01:03:16Z","timestamp":1787360596272,"version":"build-2736575974"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Congenital ventricular septal defects (VSDs) are considered to have benign long\u2010term outcome when treated correctly in childhood. However, abnormal parameters are described in younger adults, including impaired heart rate variability (HRV). It is not known whether such abnormalities will deteriorate with age. Therefore, HRV and cardiac events, such as premature ventricular contraction, were evaluated in patients aged &gt;40 years with congenital VSDs and compared with healthy peers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 30 surgically closed VSDs (51\u00b18\u00a0years, repair at median age 6.3\u00a0years with total range 1.4\u201354\u00a0years) with 30 healthy controls (52\u00b19\u00a0years) and 30 small, unrepaired VSDs (55\u00b112\u00a0years) with 30 controls (55\u00b110\u00a0years) were all equipped with a Holter monitor for 24\u00a0hours. Compared with healthy peers, surgically closed patients had lower SD of the normal\u2010to\u2010normal (NN) interbeat interval (129\u00b137 versus 168\u00b138\u00a0ms;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), SD of the average NN intervals for each 5\u2010minute segment of a 24\u2010hour HRV recording (116\u00b135 versus 149\u00b135\u00a0ms;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01) and 24\u2010hour triangular index (31\u00b19 versus 44\u00b111;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01). SD of the NN intervals, SD of the average NN intervals for each 5\u2010minute segment of a 24\u2010hour HRV recording, and triangular index were comparable between unrepaired VSDs and healthy peers. SD of the NN intervals was &lt;100\u00a0ms in 22% of surgically closed and 10% of unrepaired VSDs, whereas controls were within normal ranges. A high number of premature ventricular contractions (&gt;200 events) was registered in 57% of surgical patients compared with 3% of controls (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01), and 53% of unrepaired VSDs compared with 10% in controls (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.01).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Adults aged &gt;40 with congenital VSDs demonstrate impaired HRV, mainly among surgically closed VSDs. More than half demonstrated a high number of premature ventricular contractions. These novel findings could indicate long\u2010term cardiovascular disturbances. This necessitates continuous follow\u2010up of VSDs throughout adulthood.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020672","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T08:55:41Z","timestamp":1630486541000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Cardiac Arrhythmias and Impaired Heart Rate Variability in Older Patients With Ventricular Septal Defects"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6705-3807","authenticated-orcid":false,"given":"Marie","family":"Maagaard","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3295-2930","authenticated-orcid":false,"given":"Filip","family":"Eckerstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-0015","authenticated-orcid":false,"given":"Vibeke E.","family":"Hjortdal","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"},{"name":"Department of Clinical Medicine Copenhagen University Copenhagen N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.03.587"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-9918"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq249"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951113002084"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.10.086"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951117000877"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951120000505"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.10.009"},{"key":"e_1_3_2_10_2","first-page":"574","article-title":"Reduced biventricular contractility during exercise in adults with small, unrepaired ventricular septal defects: an echocardiographic study","volume":"57","author":"Maagaard M","year":"2020","unstructured":"Maagaard M, Heiberg J, Redington AN, Hjortdal VE. 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