Arrhythmias & electrophysiology
Risk scores inconsistently predict sudden death and ventricular arrhythmias in repaired tetralogy of Fallot
Authors' conclusion
Risk scores are heterogeneous and imperfect for determination of those at high risk of AEs in rTOF. Use of multiple criteria alongside adjuvant stratification strategies and multidisciplinary discussion remains necessary.
Study context
- Population
- Patients with repaired tetralogy of Fallot (rTOF) without a secondary prevention ICD indication or severe left ventricular impairment
- Participants
- 156 patients
- Exposure
- Prediction of a "high-risk" cohort, using a 4% predicted AE threshold, compared across 5 published scores and 3 clinical management guidelines
- Outcome
- Observed AEs
- Follow-up
- Median of 24 months (IQR 15-36 months)
Methodological detailsinstitutional database
- Institutional database
Main finding
As reported in the abstract
Adverse events (AEs)
4
Sustained VTs
3
Sudden death
1
Observational data: associations, not effects.
Further findings
Risk score variability affecting assignment of high-risk status
- Patients with risk score variability
- 41%
- n
- 64
Heterogeneity in predicted AE risk
- Associated with moderate or worse right ventricular impairment or significant late gadolinium enhancement
- P < 0.001
Prediction of observed AEs by criteria
- Events only predicted by 1 score
- 2
- No criteria predicted all AEs
Cohort characteristics
- Median age
- 32, interquartile range [IQR] 25-46 years
- Female
- 53%
ICD implantation
- ICD implants
- Seven
- Sustained VT episodes treated
- 3
Safety
- Device-related complications
- 3
Original publication
Risk scores inconsistently predict sudden death and ventricular arrhythmias in repaired tetralogy of Fallot. Heart Rhythm. Published 6 March 2025. doi:10.
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