Maagaard M, et al. - Impaired heart rate variability (HRV), predominantly in surgically closed ventricular septal defects (VSDs), was seen among adults aged >40 with congenital VSDs. A high number of premature ventricular contractions was evident in more than half of cases. Long‐term cardiovascular disturbances could be suggested by findings of this study, and thus continuous follow‐up of VSDs throughout adulthood is necessary.

• Overall 30 surgically closed VSDs (51±8 years) with 30 healthy controls (52±9 years) and 30 small, unrepaired VSDs (55±12 years) with 30 controls (55±10 years) were included.

• Lower SD of the normal‐to‐normal (NN) interbeat interval (129±37 vs 168±38 ms), SD of the average NN intervals for each 5‐minute segment of a 24‐hour HRV recording (116±35 vs 149±35 ms) and 24‐hour triangular index (31±9 vs 44±11) was noted in surgically closed patients vs healthy peers.

• In 22% of surgically closed and 10% of unrepaired VSDs, SD of the NN intervals was <100 ms, whereas it was within normal ranges in controls.

• The number of premature ventricular contractions (>200 events) was high in 57% of surgical patients vs 3% of controls, and 53% of unrepaired VSDs vs 10% in controls.