Clinical and Electrophysiological Characteristics of Inducible Polymorphic Ventricular Tachycardia in Repaired Tetralogy of Fallot
Authors' conclusion
Patients with inducible PVT display a lower clinical risk profile and healthier myocardial substrate than those with MVT. Organized beats at episode onset appear to be associated with anatomical isthmuses that can be targeted by catheter ablation.
Study context
- Population
- Patients with repaired tetralogy of Fallot (TOF) from the CATAPULT-TOF registry with inducible sustained polymorphic ventricular tachycardia (PVT) at index electrophysiology studypatients, sustained PVT induced at 27 procedures (15%)
- Participants
- 186 patients
- Exposure
- Patients with PVT vs monomorphic ventricular tachycardia (MVT)
- Outcome
- Clinical and substrate characteristics, PVT vs MVT
Methodological detailsongoing, centrally adjudicated
- Ongoing
- Centrally adjudicated
Main finding
As reported in the abstract
- More likely to undergo operation in the current era (PVT)
- P = 0.008
- Not require palliative shunt (PVT)
- P = 0.01
- Lower right ventricular end-diastolic volume/left ventricular end-diastolic volume ratio (PVT)
- P = 0.02
- Faster anatomical isthmus conduction velocity (PVT)
- P = 0.03
Observational data: associations, not effects.
Further findings
Number of TO beats and ≥1 anatomical isthmus
- Median TO beats, ≥1 anatomical isthmus vs none
- median 3 vs 0 beats; P = 0.001
- Of those with available electrocardiography data
Proportion with transiently organized PVT (TO-PVT) with catheter ablation
- Baseline
- 14 of 24 identified at baseline (58%; median 3.5 beats; cycle length 181 milliseconds)
- Postablation
- 3 (23%) of 13
- Follow-up electrophysiology study
- 1 (8%) of 13
- Trend
- P for trend = 0.001
Original publication
Clinical and Electrophysiological Characteristics of Inducible Polymorphic Ventricular Tachycardia in Repaired Tetralogy of Fallot. JACC Clin Electrophysiol. Published 24 April 2025. doi:10.
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