Mechanoelectrical Interaction in Tetralogy of Fallot

• DOI: 10.1161/01.cir.92.2.231
• Publication Date: 2012-06-12T00:34:42Z
• Authors: Michael A. Gatzoulis; Jan A. Till; Jane Somerville; Andrew N. Redington
• Keywords: Tetralogy

Life-threatening ventricular arrhythmia and sudden death remain serious late complications after tetralogy of Fallot repair. Nevertheless, there remains no clear way predicting which patients are at risk.The study population included a total 178 adult survivors (mean follow-up, 21.4 years) repair who were currently attending our clinic. Mechano-electrical relations sought in 41 the 23.6 operated on by one surgeon prospectively studied with 12-lead ECG, chest radiography, two-dimensional Doppler echocardiography. Nine 17 from group identified as having had sustained tachycardia (8 near-miss death), their ECGs, Holter monitor readings, electrophysiological studies, radiographs reviewed. The case notes an additional 4 postoperative cardiac also available for review. QRS duration whom mechanoelectrical interaction was ranged between 90 200 milliseconds correlated cardiothoracic ratio (CTR) radiography (r = .64, P < .001) right size echocardiography .43, .02). Twenty restrictive physiology (reduced compliance) mean 129.3 +/- 20 CTR 0.51 0.03. remaining 21 evidence restriction prolonged 157.5 13.2 (P 0.55 0.04 .04) compared restrictive. In 9 tachycardia, 180 to 230 (mean, 198.9 17.6 milliseconds), 0.54 0.9 0.67 0.12) .0001 .01, respectively, without life-threatening arrhythmias). All documented > or (100% sensitivity).Chronic volume overload is related diastolic function prolongation. risk symptomatic high when marked enlargement prolongation develop. A resting ECG most sensitive predictor arrhythmias yet described.