TY - JOUR
T1 - Arrhythmias in Repaired Tetralogy of Fallot
T2 - A Scientific Statement from the American Heart Association
AU - Krieger, Eric V.
AU - Zeppenfeld, Katja
AU - Dewitt, Elizabeth S.
AU - Duarte, Valeria E.
AU - Egbe, Alexander C.
AU - Haeffele, Christiane
AU - Lin, Kimberly Y.
AU - Robinson, Melissa R.
AU - Sillman, Christy
AU - Upadhyay, Shailendra
N1 - Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - 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.
AB - 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.
KW - AHA Scientific Statements
KW - arrhythmias, cardiac
KW - tachycardia, ventricular
KW - tetralogy of Fallot
UR - http://www.scopus.com/inward/record.url?scp=85142400609&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85142400609&partnerID=8YFLogxK
U2 - 10.1161/HAE.0000000000000084
DO - 10.1161/HAE.0000000000000084
M3 - Review article
C2 - 36263773
AN - SCOPUS:85142400609
SN - 1941-3149
VL - 15
SP - E000084
JO - Circulation: Arrhythmia and Electrophysiology
JF - Circulation: Arrhythmia and Electrophysiology
IS - 11
ER -