@misc{cogprints4598,
volume = {5},
number = {4},
month = {October},
author = {Antonio Franco Folino and Luciano Daliento},
editor = {Balbir Singh and Yash Lokhandwala and Johnson Francis and Anup Gupta},
title = {Arrhythmias After Tetralogy of Fallot Repair
},
publisher = {Indian Pacing and Electrophysiology Group},
year = {2005},
journal = {Indian Pacing and Electrophysiology Journal},
pages = {312--324},
keywords = {Tetralogy of Fallot, surgery; ventricular arrhythmias; risk stratification},
url = {http://cogprints.org/4598/},
abstract = {Tetralogy of Fallot is the most common cyanotic congenital heart disease, with a good outcome after total surgical correction. In spite of a low perioperative mortality and a good quality of life, late sudden death remains a significant clinical problem, mainly related to episodes of sustained ventricular tachycardia and ventricular fibrillation. Fibro-fatty substitution around infundibular resection, intraventricular septal scar, and patchy myocardial fibrosis, may provide anatomical substrates of abnormal depolarization and repolarization causing reentrant ventricular arrhythmias.
Several non-invasive indices based on classical examination such as ECG, signal-averaging ECG, and echocardiography have been proposed to identify patients at high risk of sudden death, with hopeful results. In the last years other more sophisticated invasive and non-invasive tools, such as heart rate variability, electroanatomic mapping and cardiac magnetic resonance added a relevant contribution to risk stratification.
Even if each method per se is affected by some limitations, a comprehensive multifactorial clinical and investigative examination can provide an accurate risk evaluation for every patient}
}