Document Detail

Unexpected cardiac arrest in patients after surgical correction of tetralogy of Fallot.
MedLine Citation:
PMID:  1157284     Owner:  NLM     Status:  MEDLINE    
Four of 220 patients without bifasicular block (complete right bundle branch block and left anterior hemiblock) or transient complete heart block immediately after surgery had an unexpected cardiac arrest one to 15 years after satisfactory surgical repair of tetralogy of Fallot. The postoperative electrocardiograms (ECG) revealed complete right bundle branch block in two patients and no intraventricle conduction abnormality in two patients. Each of the four patients had premature ventricular contractions on previous postoperative ECG. The cardiac arrest occurred during normal activity in three patients and mild exercise in one. Following the cardiac arrest, three patients died and one patient survived. Eighteen months before the cardiac arrest, the survivor had a stress test which revealed multifocal premature ventricular contractions with short bursts of ventricular tachycardia after exercise. This ventricular arrhythmia was suppressed with quinidine therapy. Although complete heart block cannot be excluded in these four patients, we reasoned that the cardiac arrests were probably preceded by ventricular tachyarrhythmia. Because of this experience, we believe that any patient who has had intraventricular surgery should be evaluated for ventricular arrhythmia. If frequent premature ventricular contractions or serious ventricular arrhythmias are documented, we seriously consider antiarrhythmic therapy in an attempt to prevent ventricular tachyarrhythmias and sudden death.
F W James; S Kaplan; T C Chou
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  52     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1975 Oct 
Date Detail:
Created Date:  1975-11-26     Completed Date:  1975-11-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  691-5     Citation Subset:  AIM; IM    
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MeSH Terms
Bundle-Branch Block / drug therapy,  etiology
Death, Sudden
Heart Arrest / etiology*,  prevention & control
Postoperative Complications*
Tetralogy of Fallot / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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