| Induction of sustained ventricular tachycardia after surgical repair of tetralogy of Fallot. | |
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MedLine Citation:
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PMID: 10235097 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Between 1980 and 1996, 89 unselected consecutive patients with repaired tetralogy of Fallot (TOF) underwent examination, including a prospective right ventricular programmed stimulation with the same protocol (S1 S2, S3, S4). Age at surgery was 4.2 +/- 3.5 years and age at electrophysiologic study was 10.9 +/- 6.5 years. Follow-up since surgery was 14.4 +/- 4.8 years and patient follow-up after programmed stimulation was 7.8 +/- 4.2 years. The aim of this study was to evaluate the main predictors of the inducibility of a sustained monomorphic ventricular tachycardia (VT) and its significance to identify a group of patients at risk of sudden death: 21 (group A) had and 68 (group B) had no induced sustained VT. The induction of VT was related to older age at programmed stimulation, prolonged QRS duration, presence of complex ventricular arrhythmia, symptoms, right ventricular overload, and increased right ventricular systolic pressure. Predictors of induced VT selected by multivariate analysis were age at electrophysiologic study (p <0.0001), previous palliative shunts (p <0.001), right ventricular systolic pressure (p <0.007), and symptoms (p <0.005). Among group A patients, 4 had previous sustained VT before stimulation, and 1 had sustained VT only during follow-up after stimulation. No patients of group B had clinical sustained VT. Late mortality was low but similar between both groups. A negative electrophysiologic study may be helpful for the management of patients after surgical repair of TOF, but because the arrhythmic event rate is low, the findings of even a positive electrophysiologic study should be interpreted with caution. |
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Authors:
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H Lucron; F Marçon; G Bosser; J P Lethor; P Y Marie; B Brembilla-Perrot |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 83 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1999 May |
Date Detail:
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Created Date: 1999-05-20 Completed Date: 1999-05-20 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1369-73 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology, Centre Hospitalier et Universitaire de Nancy, Vandoeuvre-les-Nancy, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Child Child, Preschool Electric Stimulation Female Humans Infant Male Postoperative Period Predictive Value of Tests Prognosis Prospective Studies Radionuclide Angiography Tachycardia, Ventricular / physiopathology* Tetralogy of Fallot / surgery* Ventricular Premature Complexes / physiopathology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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