@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} }