Late ventricular tachycardia after repair of tetralogy of Fallot

  • F. Marçon
  • C. Pernot
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 71)


Because of recent advances in surgical techniques and postoperative care, the number of patients surviving correction of congenital heart defects is becoming significant and the long-term sequelae of these repairs are assuming greater importance. Long-term electrophysiologic consequences of repair of tetralogy of Fallot (TOF) include atrioventricular and intraventricular conduction defects, sinus node dysfunction and ventricular arrhythmias. An increasing amount of evidence suggests that malignant ventricular arrhythmias are a cause of late sudden death in patients after repair of TOF and apparented malformations with obstruction of the right ventricular outflow tract (ventricular septal defect associated with pulmonary valve stenosis, double outlet right ventricle, truncus arteriosus). Recent attention, therefore, has been focused on the detection, prevention and treatment of ventricular arrhythmias in these patients.


Sudden Death Ventricular Tachycardia Ventricular Arrhythmia Ventricular Septal Defect Right Bundle Branch Block 
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  1. 1.
    James FJ, Kaplan S, Chou TC. 1975. Unexpected cardiac arrest in patients after surgical correction of tetralogy of Fallot. Circulation 52: 691–695.PubMedGoogle Scholar
  2. 2.
    Quattelbaum TG, Varghese PJ, Neill CA, Donahoo JS. 1976. Sudden death among postoperative patients with tetralogy of Fallot. A follow-up study of 243 patients for an average of twelve years. Circulation 54: 289–293.Google Scholar
  3. 3.
    Gillette PC, Yeoman MA, Mullins CE, McNamara DG. 1977. Sudden death after repair of tetralogy of Fallot. Electrocardiographic and electrophysiologic abnormalities. Circulation 56: 566–571.PubMedGoogle Scholar
  4. 4.
    Garson A, Nihill MR, McNamara DG, Cooley DA. 1979. Status of the adult and adolescent after repair of tetralogy of Fallot. Circulation 59:1232–1240.PubMedGoogle Scholar
  5. 5.
    Deanfield JE, Mc Kenna WJ, Hallidie-Smith KA. 1980. Detection of late arrhythmia and conduction disturbance after correction of tetralogy of Fallot. Br Heart J 44: 248–253.PubMedCrossRefGoogle Scholar
  6. 6.
    Wessel HU, Bastanier CK, Parel NH, Berry TE, Cole RB, Muster AJ. 1980. Pronostic significance of arrhythmia in tetralogy of Fallot after intracardiac repair. Am J Cardiol 46: 843–848.PubMedCrossRefGoogle Scholar
  7. 7.
    Kavey REW, Blackman MS, Sondheimer HM. 1982. Incidence and severity of chronic ventricular dysrhythmias after repair of tetralogy of Fallot. Am Heart J 103: 342–350.PubMedCrossRefGoogle Scholar
  8. 8.
    Tamer D, Wolff GS, Ferrer P, Pickoff AS, Casta A, Metha AV, Garcia O, Gelband H. 1983. Hemodynamics and intracardiac conduction after operative repair of tetralogy of Fallot. Am J Cardiol 1: 552–556.CrossRefGoogle Scholar
  9. 9.
    Garson A, Randall DC, Gillette PC, Smith RT, Moak JP, Mc Vey P, McNamara DG. 1985. Prevention of sudden death after repair of tetralogy of Fallot: treatment of ventricular arrhythmias. J Am Coll Cardiol 6: 221–227.PubMedCrossRefGoogle Scholar
  10. 10.
    Matina D, Mouly A, Massol J, Gatau-Pelanchon J, Blin D, Langlet F, Levy S, Monties JR, Gerard R. 1985. Troubles du rhythme ventriculaire après réparation de tétralogie de Fallot. A propos de 59 cas. Arch Mal Coeur 78:103–110.PubMedGoogle Scholar
  11. 11.
    Garson A, Gillette PC, Gutgesell HP, McNamara DG. 1980. Stress-induced ventricular arrhythmia after repair of tetralogy of Fallot. Am J Cardiol 46: 1006–1012.PubMedCrossRefGoogle Scholar
  12. 12.
    Garson A, McNamara DG. 1985. Sudden death in a pediatric cardiology population, 1958 to 1983: relation to prior arrhythmias. J Am Coll Cardiol 5:134B-137B.CrossRefGoogle Scholar
  13. 13.
    Katz NM, Blackstone EH, Kirklin JW, Pacifico AD, Bargeron LM. 1982. Late survival and symptoms after repair of tetralogy of Fallot. Circulation 65: 403–410.PubMedCrossRefGoogle Scholar
  14. 14.
    Kulbertus HE, Coyne JJ, Hallidie-Smith KA. 1969. Conduction disturbances before and after surgical closure f ventricular septal defect. Am Heart J 77:123–131.PubMedCrossRefGoogle Scholar
  15. 15.
    Wolff GS, Rowland TW, Ellison RC. 1972. Surgically induced right bundle branch block with left anterior hemiblock. Circulation 45: 587–593.Google Scholar
  16. 16.
    Moss AJ, Klyman G, Emmanouilides GC. 1972. Late onset complete heart block. Am J Cardiol 30: 884.PubMedCrossRefGoogle Scholar
  17. 17.
    Krongrad E. 1978. Prognosis for patients with congenital heart disease and postoperative intraventricular conduction defects. Circulation 57: 867–869.PubMedGoogle Scholar
  18. 18.
    Cairns J A, Dobell ARC, Gibbons JE, Tessler I.1975. Prognosis of right bundle branch block and left anterior hemiblock after intracardiac repair of tetralogy of Fallot. Am Heart J 90: 549–554.PubMedCrossRefGoogle Scholar
  19. 19.
    Downing JW, Kaplan S, Bove KE. 1972. Postchirurgical left anterior hemiblock and right bundle branch block. Br Heart J 34: 263–270.PubMedCrossRefGoogle Scholar
  20. 20.
    Steeg CN, Krongrad E, Davachi F, Bowman FO, Malm JR, Gersony WM. 1975. Postoperative left anterior hemiblock and right bundle branch block following repair of tetralogy of Fallot: clinical and etiologic consideration. Circulation 51: 1026–1029.PubMedGoogle Scholar
  21. 21.
    Deanfield JE, Ho SY, Anderson RH, McKenna WJ, Allwork SP, Hallidie-Smith KA. 1983. Late sudden death after repair of tetralogy of Fallot: a clinicopathologic study. Circulation 67:626–631.PubMedCrossRefGoogle Scholar
  22. 22.
    Kobayashi J, Hirose H, Ivakano S, Matsuda H, Shirakura R, Kawashima Y. 1984. Ambulatory electrocardiographic study of the frequency and cause of ventricular arrhythmia after correction of tetralogy of Fallot. Am J Cardiol 54:1310–1313.PubMedCrossRefGoogle Scholar
  23. 23.
    Cloez JL, Khalife K, Weber JL, Aliot E, Marçon F, Pernot C. 1984. Tachycardies ventriculaires tardives après correction chirurgicale d’une cardiopathie congénitale. Incidence, sévérité et facteurs prédictifs. Arch Mal Coeur 77: 534–542.PubMedGoogle Scholar
  24. 24.
    Deanfield JEV, Franklin R, McKenna WJ, Dickie S, Gersony W, Hallidie-Smith KA. 1985. Prognostic significance of ventricular arrhythmia after repair of tetralogy of Fallot. A prospective study. (Abstract). Br Heart J 53: 676.Google Scholar
  25. 25.
    Fuster V, McGoon DC, Kennedy MA, Ritter DG, Kirklin JW. 1980. Long-term evaluation (12 to 22 years) of open heart surgery for tetralogy of Fallot. Am J Cardiol 46:635–642.PubMedCrossRefGoogle Scholar
  26. 26.
    Kugler JD, Pinsky WW, Cheatham JP, Hofchire PJ, Mooring PK, Fleming WH. 1983. Sustained ventricular tachycardia after repair of tetralogy of Fallot: new electrophysiologic findings. Am J Cardiol 51: 1137–1143.PubMedCrossRefGoogle Scholar
  27. 27.
    Kavey REW, Thomas FD, Byrum GJ, Blackman MS, Sondheimer HM, Bove EL. 1984. Ventricular arrhythmias and biventricular dysfunction after repair of tetralogy of Fallot. J Am Coll Cardiol 4: 126–131.PubMedCrossRefGoogle Scholar
  28. 28.
    Reduto AL, Berger HJ, Johnstone DE, Hellenbrand W, Wackers FJT, Whittemore R, Cohen LS, Gottschalk A, Zaret B. 1980. Radionuclide assessment of right and left ventricular exercise reserve after total correction of tetralogy of Fallot. Am J Cardiol 45:1013–1018.PubMedCrossRefGoogle Scholar
  29. 29.
    Parrish MD, Graham TP, Born ML, Jones J. 1982. Radionuclide evaluation of right and left ventricular function in children: validation of methodology. Am J Cardiol 49:1241–1247.PubMedCrossRefGoogle Scholar
  30. 30.
    Brunotte F, Marçon F, Cloez JL, Laurens MH, Itty C, Robert J, Pernot C. 1985. Apprt des radioisotopes à l’étude de la fonction ventriculaire droite et gauche dans la tétralogie de Fallot opérée. Arch Mal Coeur 78: 771–776.PubMedGoogle Scholar
  31. 31.
    Garson A, Porter CJ, Gillette PC, McNamara DG. 1983. Induction of ventricular tachycardia during electrophysiologic study after repair of tetralogy of Fallot. J Am Coll Cardiol 1:1493–1502.PubMedCrossRefGoogle Scholar
  32. 32.
    Martin R, Khagani A, Radley-Smith R, Yacoub M. 1985. Patient status 10 or more years after primary total correction of tetralogy of Fallot under the age of 2 years (Abstract.). Br Heart J 53: 666.Google Scholar
  33. 33.
    Horowitz LN, Vetter VL, Harken AH, Josephson ME. 1980. Electrophysiologic characteristics of sustained ventricular tachycardia occurring after repair of tetralogy of Fallot. Am J Cardiol 46: 446–452.PubMedCrossRefGoogle Scholar
  34. 34.
    Marin-Garcia J, Moller JH. 1977. Sudden death after operative repair of tetralogy of Fallot. Br Heart J 39: 1380–1385.PubMedCrossRefGoogle Scholar
  35. 35.
    Mehta AV, Sanchez GR, Donner RM, O’Riordan AC, Black IFS. 1983. New electrophysiologic findings after repair of tetralogy of Fallot (Abstract.). J Am Coll Cardiol 1 (suppl. 2): 614.Google Scholar
  36. 36.
    Vetter VL, Horowitz LN. 1982. Electrophysiologic results of repair of tetralogy of Fallot. Am J Cardiol 49: 999–1003.CrossRefGoogle Scholar
  37. 37.
    Gillette PC, Garson A. 1981. Intracardiac electrophysiologic studies: use in determining the site and mechanisms of dysrhythmias. In: Gillette PC, Garson A (eds) Pediatric Cardiac Dysrhythmias. New York: Grune and Stratton, 77–120.Google Scholar
  38. 38.
    Garson A. 1984. Ventricular dysrhythmias after congenital heart surgery: a canine model. Pediatr Res 18:1112–1120.PubMedCrossRefGoogle Scholar
  39. 39.
    Lock JE, Castaneda-Zuniga WR, Fuhrman BP, Bass JL. 1983. Balloon dilatation angioplasty of hypoplastic and stenotic pulmonary arteries. Circulation 67: 962–967.PubMedCrossRefGoogle Scholar
  40. 40.
    Garson A, Kugler JD, Gillette PC, Simonelli A, McNamara DG. 1980. Control of late postoperative ventricular arrhythmias with phenytoin in young patients. Am J Cardiol 46: 290–294.PubMedCrossRefGoogle Scholar
  41. 41.
    Garson A, Gillette PC, McVey P, Hesslein PS, Porter CJ, Angelí LK, Kaldis LC, Hittnner HM. 1984. Amiodarone treatment of critical arrhythmias inn children and young adults. J Am Coll Cardiol 4: 749–755.CrossRefGoogle Scholar
  42. 42.
    Harken AH, Horowitz LN, Josephson ME. 1980. Surgical correction of recurrent sustained ventricular tachycardia following complete repair of tetralogy of Fallot. J Thorac Cardiovasc Surg 80: 779–781.PubMedGoogle Scholar
  43. 43.
    Horowitz LN, Josephson ME, Farshidi A, Spielman SR, Michelson EL, Greenspan AM. 1978. Recurrent sustained ventricular tachycardia. 3. Role of the electrophysiologic study in selection of antiarrhythmic regimens. Circulation 58: 986–997.PubMedGoogle Scholar
  44. 44.
    Josephson ME, Horowitz LN. 1979. Electrophysiologic approach to therapy of recurrent sustained ventricular tachycardia. Am J Cardiol 43: 631–642.PubMedCrossRefGoogle Scholar
  45. 45.
    Kugler JD, Bansal AM, Cheatham JP, Pinsky WW, Moorine PK, Hofschire PJ. 1985. Drug-electrophysiology studies in infants, children and adolescents. Am Heart J 110:144–154.PubMedCrossRefGoogle Scholar

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© Martinus Nijhoff Publishers, Dordrecht 1987

Authors and Affiliations

  • F. Marçon
  • C. Pernot

There are no affiliations available

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