Systematic Electrophysiological Study Prior to Pulmonary Valve Replacement in Tetralogy of Fallot: A Prospective Multicenter Study
Authors' conclusion
Systematically performing programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR yields a high rate of inducible ventricular tachycardia and carries the potential to alter management.
Study context
- Population
- Patients with tetralogy of Fallot referred for pulmonary valve replacement (PVR), January 2020 to December 2021
- Participants
- 120 patients
- Outcome
- Inducible sustained VT on programmed ventricular stimulation
Methodological detailsmulticentre, standardized stimulation protocol
- Multicentre
- Standardized stimulation protocol
Main finding
As reported in the abstract
Sustained VT induced
27
22.5%
Critical isthmus between VSD patch and pulmonary annulus (when identifiable)
90.0%
Observational data: associations, not effects.
Further findings
Factors independently associated with inducible VT
| OR (95% CI) | ||
|---|---|---|
| History of atrial arrhythmia | 8.56 (2.43–34.73) | |
| Pulmonary annulus diameter >26 mm | 5.05 (1.47–21.69) | |
| 0.050.21520Odds ratio (log scale) |
Change in management after electrophysiological studies (EPS)
- Substantial change in management
- 23 (19.2%)
- Catheter ablation
- 18 (15.0%)
- Surgical cryoablation during PVR
- 3 (2.5%)
- Defibrillator implantation
- 9 (7.5%)
Repeat EPS after PVR negative · 5.1 (4.8-6.2) months after PVR
- Negative repeat EPS
- 8 of 9 (88.9%)
Sustained ventricular arrhythmia during follow-up · 13 (6.1-20.1) months
- Patients with sustained ventricular arrhythmia
- 0
Original publication
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