Objective-To study the incidence, predisposing factors, and clinical significance of arrhythmias early and late after the Fontan operation for congenital heart disease.Patients and methods-All 104 consecutive patients undergoing Fontan repair from 1975 to 1988 were studied retrospectively. Hospital records were reviewed for perioperative arrhythmia. Clinical information and annual electrocardiograms were available for all 78 hospital survivors during a follow up of up to 13 years (mean 3'7 years).Ambulatory electrocardiographic monitoring was performed in 67 patients (81%).Results-Eleven patients (10-6%) developed a perioperative tachycardia (eight, atrial flutter; three, His bundle tachycardia). Multivariate analysis showed that raised preoperative mean pulmonary artery pressure and low aortic saturation were significant risk factors for the development of atrial flutter (r2 = 0-32, p = 00001) but not for His bundle tachycardia. Despite

Objective-To determine the life and health insurability and employability of young adults with congenital heart disease. Design-Questionnaire study. Setting-Cardiac department of a tertiary referral hospital for children. Patients-Young adults 18-30 years old with a variety of congenital heart defects, both simple and complex, including postoperative patients. Main outcome measures-Availability of insurance at normal or high rates, with or without special conditions or exclusions. Prospects for employment.

clinical setting, NO is inexpensive, easy to administer in a respiratory gas mixture, and has been reported to cause selective pulmonary vasodilatation in neonates with persistent pulmonary hypertension,7 8 children with con-