CONGENITAL HEART DISEASE
Ventricular Late Potentials and Induced Ventricular Arrhythmias After Surgical Repair of Tetralogy of Fallot Marc Zimmermann, MD, Beat Friedli, MD, Richard Adamec, MD, and lngrid Oberh%sli, MD
Ventricular tachycardia (VT) and sudden death are rare but recognized complications after surgical repair of tetralogy of Fallot. We prospectively studied 31 patients (19 boys and 12 girls, mean age f standard deviation 7 f 4 years) with postoperative tetralogy of Fallot, by means of right-sided cardiac catheterization, 24-hour Holter monitoring, body-surface and intracavitary signal-averaging (gain lo5 to 106, filters of 100 and 300 Hz) and programmed ventricular stimulation (1 and 2 extrastimuli, 3 basic cycle lengths, right ventricular apex and outflow tract). All patients were asymptomatic and none had documented or suspected ventricular arrhythmias. Ventricular late potentials were detected in 10 of 31 patients (32%) and spontaneous ventricular arrhythmias in 12 of 31 patients (39%). No sustained VT was induced by programmed ventricular stimulation but nonsustained VT was induced in 3 patients (10%). Patients with inducible VT more often had late potentials (3 of 3 vs 7 of 29, p 30 secondsor requiring direct-current shock because ventricular sites (apex and outflow tract). For each of hemodynamic compromise. NONSUSTAINED VENTRICULAR TACHYCARDIA: 23 conelectrode position, 2 3 signal-averagedrecordings were obtained to confirm the reproducibility of any abnor- secutive VPCs at a rate of >lOO beats/min, but selfmal signal detected. terminating within 30 seconds.5 Statistical analysis: Numerical data were compared Electrophysiologic study: Electrophysiologic evaluation was performed during postoperativecardiac cathe- using Student’s t test for unpaired data. Categorical terization. At the time of the study, no patient was re- data were comparedusing chi-square analysis.A p valceiving antiarrhythmic therapy. Premeditation (2 ml ue
Ventricular Late Potentials and Induced Ventricular Arrhythmias After Surgical Repair of Tetralogy of Fallot Marc Zimmermann, MD, Beat Friedli, MD, Richard Adamec, MD, and lngrid Oberh%sli, MD
Ventricular tachycardia (VT) and sudden death are rare but recognized complications after surgical repair of tetralogy of Fallot. We prospectively studied 31 patients (19 boys and 12 girls, mean age f standard deviation 7 f 4 years) with postoperative tetralogy of Fallot, by means of right-sided cardiac catheterization, 24-hour Holter monitoring, body-surface and intracavitary signal-averaging (gain lo5 to 106, filters of 100 and 300 Hz) and programmed ventricular stimulation (1 and 2 extrastimuli, 3 basic cycle lengths, right ventricular apex and outflow tract). All patients were asymptomatic and none had documented or suspected ventricular arrhythmias. Ventricular late potentials were detected in 10 of 31 patients (32%) and spontaneous ventricular arrhythmias in 12 of 31 patients (39%). No sustained VT was induced by programmed ventricular stimulation but nonsustained VT was induced in 3 patients (10%). Patients with inducible VT more often had late potentials (3 of 3 vs 7 of 29, p 30 secondsor requiring direct-current shock because ventricular sites (apex and outflow tract). For each of hemodynamic compromise. NONSUSTAINED VENTRICULAR TACHYCARDIA: 23 conelectrode position, 2 3 signal-averagedrecordings were obtained to confirm the reproducibility of any abnor- secutive VPCs at a rate of >lOO beats/min, but selfmal signal detected. terminating within 30 seconds.5 Statistical analysis: Numerical data were compared Electrophysiologic study: Electrophysiologic evaluation was performed during postoperativecardiac cathe- using Student’s t test for unpaired data. Categorical terization. At the time of the study, no patient was re- data were comparedusing chi-square analysis.A p valceiving antiarrhythmic therapy. Premeditation (2 ml ue
