Congenital heart diseaseCohort study
Proactive Mapping and Preventive Ablation Reduce Defibrillator Implantation Rates in Tetralogy of Fallot
- Cohort study
- consecutive patients
- retrospective implantable cardioverter-defibrillator (ICD) eligibility assessment
Authors' conclusion
Long-term outcome of rTOF patients without SCAI is excellent. Proactive electroanatomical mapping and preventive SCAI ablation may significantly reduce primary prevention ICD implantation rates compared with current risk prediction methods.
Study context
- Population
- Repaired tetralogy of Fallot patients without prior ventricular tachycardia (VT) undergoing electroanatomical mapping, 2005–2020
- Participants
- 97 participants
- Exposure
- Proactive mapping and preventive slow-conducting anatomical isthmus (SCAI) ablation vs current risk stratification methods for primary prevention ICD selection
- Outcome
- Patients qualifying for primary prevention ICD by each method; long-term VT outcome
- Follow-up
- Median 58 months
Main finding
As reported in the abstract
Patients qualifying for primary prevention ICD, by selection method
- VT during follow-up (all after ablation failure); all 4 among remaining ICD candidates
- 4 (4%)
- Annual VT risk among remaining ICD candidates
- 7%/y
Observational data: associations, not effects.
Further findings
VT during follow-up · median 58 months (Q1-Q3: 30-99 months)
- Patients with VT, all after ablation failure
- 4 (4%)
- Annual VT risk among remaining ICD candidates
- 7%/y
- all 4 with VT among the 11 remaining ICD candidates
SCAI and inducible VT
- SCAI present
- 33 (34%)
- Inducible monomorphic VT
- 19 (20%)
- Successful SCAI transection
- 87% (26 of 30)
- ICD implanted
- 13
Safety
Complications of SCAI ablation
- SCAI transection without complications
Original publication
Proactive Mapping and Preventive Ablation Reduce Defibrillator Implantation Rates in Tetralogy of Fallot. J Am Coll Cardiol. Published 6 May 2025. doi:10.1016/j.jacc.2025.03.523
Summarised from the published abstract; every number is checked against it