Despite advances in the clinical management of congenital and paediatric heart disease, these areas of therapy remain challenging, often with no established consensus regarding optimal treatment. In a collaborative project between the Pediatric & Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS), an international consensus has been agreed on the optimal treatment of ventricular arrhythmias in children with structurally normal hearts, and of arrhythmias in adults with congenital heart disease. These statements are published in the journal Heart Rhythm.

The paper on paediatric arrhythmias by Crosson et al. includes a standardized method for the diagnosis of a range of rare, potentially fatal, paediatric heart conditions that can appear similar to idiopathic ventricular tachycardia, which is usually benign. The statement on arrhythmias in adult congenital heart disease by Khairy and colleagues reflects changing mortality patterns. Survival beyond 1 year of age was 25% 50 years ago, compared with >90% expected survival to adulthood today. This change highlights a need for consensus on the treatment of adults with arrhythmias and underlying congenital heart disease, an area with increasing patient numbers.

Each statement was devised by a panel of experts representing cardiology societies, such as the ACC and AHA. For consensus to be reached, a thorough review of the literature was performed, evaluating the relative merits of each reported clinical approach. In more specialist areas, particularly for aspects of paediatric cardiology in which published evidence is limited, a consensus of ≥75% was reached on the combined basis of published evidence and the experience of the writing committee.

These consensus statements are an important standardization of the clinical management of arrhythmias in children and adults with congenital heart disease that will, hopefully, result in improved patient outcomes.