Congenital heart diseaseCohort study
Tetralogy of Fallot: electrophysiology-guided surgical ablation during pulmonary valve replacement
- Prospective cohort study
- multicentre
Authors' conclusion
In adults with repaired TOF undergoing PVR, inducible VT is common. An EP-guided surgical strategy is associated with greater post-operative non-inducibility and improved long-term arrhythmic outcomes compared with empiric ablation.
Study context
- Population
- Consecutive adults with repaired tetralogy of Fallot undergoing surgical pulmonary valve replacement (2005–22)91 (45.1%) inducible ventricular tachycardia (VT)
- Participants
- 204 adults
- Exposure
- Electrophysiological (EP)-guided vs empiric surgical ablation during pulmonary valve replacement (PVR)
- Outcome
- Post-operative VT inducibility and long-term clinical VT/sudden cardiac death (SCD)
Main finding
As reported in the abstract
Post-operative VT non-inducibility (ablated patients)
Adjusted odds ratio
20.4
95% CI 4.5–91.8
P < 0.0001
By group
EP-guided vs Empiric
adjusted OR 20.4 (95% CI 4.5–91.8); P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| VT/SCD, persistent post-operative inducibility vs no pre-operative inducible VT · median 10.2-year follow-up | adjusted HR 5.3 (95% CI 1.8–16.0) | P = 0.003 | |
| VT/SCD by ablation strategy vs no pre-operative inducible VT · median 10.2-year follow-up — Empiric vs No inducible VT pre-operatively | HR 5.2 (95% CI 1.6–16.5) | P = 0.005 | |
| VT/SCD by ablation strategy vs no pre-operative inducible VT · median 10.2-year follow-up — EP-guided vs No inducible VT pre-operatively | HR 2.8 (95% CI 0.8–10.3) | P = 0.228 | |
| 0.050.21520Ratio (log scale) |
Original publication
Tetralogy of Fallot: electrophysiology-guided surgical ablation during pulmonary valve replacement. Eur Heart J. Published 28 May 2026. doi:10.1093/eurheartj/ehag329
Summarised from the published abstract; every number is checked against it