Arrhythmias in Repaired Tetralogy of Fallot: A Scientific Statement from the American Heart Association

Eric V. Krieger, Katja Zeppenfeld, Elizabeth S. Dewitt, Valeria E. Duarte, Alexander C. Egbe, Christiane Haeffele, Kimberly Y. Lin, Melissa R. Robinson, Christy Sillman, Shailendra Upadhyay

Research output: Contribution to journalReview articlepeer-review


Arrhythmia and sudden cardiac death remain common in repaired tetralogy of Fallot and affect even those with excellent anatomic repairs. Atrial arrhythmia often has mechanisms different from those in acquired heart disease. Ventricular arrhythmia remains a major source of mortality in repaired tetralogy of Fallot. Noninvasive risk stratification is important to identify patients who may benefit from ablation or primary prevention implantable cardioverter defibrillators. Multiple noninvasive risk factors are associated with ventricular arrhythmia, but no universally accepted risk stratification algorithm exists. The mechanism of ventricular arrhythmia is usually attributable to a consistent and discrete set of slowly conducting anatomic isthmuses related to both the native anatomy and the consequences of the surgical repair, which interact with ventricular remodeling to provide arrhythmic substrate. This substrate can be identified during electroanatomic mapping and prophylactically ablated in appropriate patients. This scientific statement discusses the mechanisms and treatment of arrhythmia in repaired tetralogy of Fallot.

Original languageEnglish (US)
Pages (from-to)E000084
JournalCirculation: Arrhythmia and Electrophysiology
Issue number11
StatePublished - Nov 1 2022


  • AHA Scientific Statements
  • arrhythmias, cardiac
  • tachycardia, ventricular
  • tetralogy of Fallot

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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