Rapid ventricular tachycardia in patients with tetralogy of Fallot and implantable cardioverter-defibrillator: Insights from the DAI-T4F nationwide registry
Authors' conclusion
Patients with TOF and rapid VT/VF had distinct clinical characteristics. The relatively low variation of VTCL over time suggests a room for catheter ablation without a backup ICD in selected patients with well-tolerated VT.
Study context
- Population
- Patients with repaired tetralogy of Fallot and implantable cardioverter-defibrillator (ICD) since 200061 (42%) with ≥1 ventricular tachycardia (VT)/VF episode
- Participants
- 144 patients
- Exposure
- Rapid VT/VF vs nonrapid VT
- Rapid VT/VFn = 28
- Outcome
- Patient characteristics, rapid VT/VF vs nonrapid VT
- Follow-up
- Median 6.3 years (IQR 2.2-10.3 years)
Methodological detailsnationwide registry
- Nationwide registry
Main finding
As reported in the abstract
| Group | Age at ICD implantation | History of cardiac arrest | History of atrial arrhythmia | RV ejection fraction |
|---|---|---|---|---|
| Rapid VT/VF | 35.2 ± 12.6 years | 8 [29%] | 11 [42%] | 43.3% ± 10.3% |
| Nonrapid VT | 41.5 ± 11.2 years | 2 [6%] | 22 [69%] | 36.6% ± 11.2% |
Age at ICD implantation
Rapid VT/VF35.2 ± 12.6 years
Nonrapid VT41.5 ± 11.2 years
History of cardiac arrest
Rapid VT/VF8 [29%]
Nonrapid VT2 [6%]
History of atrial arrhythmia
Rapid VT/VF11 [42%]
Nonrapid VT22 [69%]
RV ejection fraction
Rapid VT/VF43.3% ± 10.3%
Nonrapid VT36.6% ± 11.2%
- Rapid VT/VF vs Nonrapid VT: P = 0.04 — age at ICD implantation
- Rapid VT/VF vs Nonrapid VT: P = 0.02 — history of cardiac arrest
- Rapid VT/VF vs Nonrapid VT: P = 0.004 — history of atrial arrhythmia
- Rapid VT/VF vs Nonrapid VT: P = 0.04 — RV ejection fraction
Observational data: associations, not effects.
Further findings
VTCL of VT/VF episodes
- Median VTCL 325 ms (IQR 235-429 ms)
Rapid VT/VF after first nonrapid VT episode · during follow-up
- No patient with a first nonrapid VT episode had rapid VT/VF
Original publication
Rapid ventricular tachycardia in patients with tetralogy of Fallot and implantable cardioverter-defibrillator: Insights from the DAI-T4F nationwide registry. Heart Rhythm. Published 26 October 2022. doi:10.
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