Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1987 Jul;58(1):40–44. doi: 10.1136/hrt.58.1.40

Is ventricular arrhythmia in repaired tetralogy of Fallot an effect of operation or a consequence of the course of the disease? A prospective study.

I D Sullivan, P Presbitero, V M Gooch, E Aruta, J E Deanfield
PMCID: PMC1277245  PMID: 3620240

Abstract

Ventricular arrhythmia is common after repair of tetralogy of Fallot. Such arrhythmia could be caused by damage at surgical repair or it could be part of the course of the disease. Fifty patients, 32 aged 1-7 years and 18 aged 13-43 years at surgical repair, underwent 24 hour electrocardiographic monitoring before and 2-75 (mean 44) months after repair. Before operation none of the younger group had appreciable ventricular arrhythmia, whereas ventricular arrhythmia was already present in eight (45%) of 18 patients in the older group. At follow up ventricular arrhythmia was present in four patients from the younger group and seven from the older group. Three of these four younger patients had had insertion of a conduit from the right ventricle to the pulmonary artery or reoperation. Six of the seven older patients had had appreciable ventricular arrhythmia before operation. New ventricular arrhythmia developed in only two (5%) of the 43 patients who had uncomplicated repair of tetralogy of Fallot. Thus the high frequency of ventricular arrhythmia after repair of tetralogy of Fallot cannot be attributed to the effect of operation alone because in the majority of patients it was already present before operation. Preoperative ventricular arrhythmia occurred almost exclusively in older patients; this suggests that early surgery may reduce the occurrence of this late complication.

Full text

PDF
40

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Deanfield J. E., Ho S. Y., Anderson R. H., McKenna W. J., Allwork S. P., Hallidie-Smith K. A. Late sudden death after repair of tetralogy of Fallot: a clinicopathologic study. Circulation. 1983 Mar;67(3):626–631. doi: 10.1161/01.cir.67.3.626. [DOI] [PubMed] [Google Scholar]
  2. Deanfield J. E., McKenna W. J., Hallidie-Smith K. A. Detection of late arrhythmia and conduction disturbance after correction of tetralogy of Fallot. Br Heart J. 1980 Sep;44(3):248–253. doi: 10.1136/hrt.44.3.248. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Deanfield J. E., McKenna W. J., Presbitero P., England D., Graham G. R., Hallidie-Smith K. Ventricular arrhythmia in unrepaired and repaired tetralogy of Fallot. Relation to age, timing of repair, and haemodynamic status. Br Heart J. 1984 Jul;52(1):77–81. doi: 10.1136/hrt.52.1.77. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Deanfield J., McKenna W., Rowland E. Local abnormalities of right ventricular depolarization after repair of tetralogy of Fallot: a basis for ventricular arrhythmia. Am J Cardiol. 1985 Feb 15;55(5):522–525. doi: 10.1016/0002-9149(85)90239-5. [DOI] [PubMed] [Google Scholar]
  5. Garson A., Jr, Randall D. C., Gillette P. C., Smith R. T., Moak J. P., McVey P., McNamara D. G. Prevention of sudden death after repair of tetralogy of Fallot: treatment of ventricular arrhythmias. J Am Coll Cardiol. 1985 Jul;6(1):221–227. doi: 10.1016/s0735-1097(85)80279-5. [DOI] [PubMed] [Google Scholar]
  6. Gillette P. C., Yeoman M. A., Mullins C. E., McNamara D. G. Sudden death after repair of tetralogy of Fallot. Electrocardiographic and electrophysiologic abnormalities. Circulation. 1977 Oct;56(4 Pt 1):566–571. doi: 10.1161/01.cir.56.4.566. [DOI] [PubMed] [Google Scholar]
  7. Horowitz L. N., Vetter V. L., Harken A. H., Josephson M. E. Electrophysiologic characteristics of sustained ventricular tachycardia occurring after repair of tetralogy of fallot. Am J Cardiol. 1980 Sep;46(3):446–452. doi: 10.1016/0002-9149(80)90014-4. [DOI] [PubMed] [Google Scholar]
  8. Jones M., Ferrans V. J. Myocardial degeneration in congenital heart disease. Comparison of morphologic findings in young and old patients with congenital heart disease associated with muscular obstruction to right ventricular outflow. Am J Cardiol. 1977 Jun;39(7):1051–1063. doi: 10.1016/s0002-9149(77)80221-x. [DOI] [PubMed] [Google Scholar]
  9. Katz N. M., Blackstone E. H., Kirklin J. W., Pacifico A. D., Bargeron L. M., Jr Late survival and symptoms after repair of tetralogy of Fallot. Circulation. 1982 Feb;65(2):403–410. doi: 10.1161/01.cir.65.2.403. [DOI] [PubMed] [Google Scholar]
  10. Kavey R. E., Blackman M. S., Sondheimer H. M. Incidence and severity of chronic ventricular dysrhythmias after repair of tetralogy of Fallot. Am Heart J. 1982 Mar;103(3):342–350. doi: 10.1016/0002-8703(82)90272-1. [DOI] [PubMed] [Google Scholar]
  11. Kavey R. E., Thomas F. D., Byrum C. J., Blackman M. S., Sondheimer H. M., Bove E. L. Ventricular arrhythmias and biventricular dysfunction after repair of tetralogy of Fallot. J Am Coll Cardiol. 1984 Jul;4(1):126–131. doi: 10.1016/s0735-1097(84)80329-0. [DOI] [PubMed] [Google Scholar]
  12. Kobayashi J., Hirose H., Nakano S., Matsuda H., Shirakura R., Kawashima Y. Ambulatory electrocardiographic study of the frequency and cause of ventricular arrhythmia after correction of tetralogy of Fallot. Am J Cardiol. 1984 Dec 1;54(10):1310–1313. doi: 10.1016/s0002-9149(84)80088-0. [DOI] [PubMed] [Google Scholar]
  13. Kugler J. D., Pinsky W. W., Cheatham J. P., Hofschire P. J., Mooring P. K., Fleming W. H. Sustained ventricular tachycardia after repair of tetralogy of Fallot: new electrophysiologic findings. Am J Cardiol. 1983 Apr;51(7):1137–1143. doi: 10.1016/0002-9149(83)90359-4. [DOI] [PubMed] [Google Scholar]
  14. Ryan M., Lown B., Horn H. Comparison of ventricular ectopic activity during 24-hour monitoring and exercise testing in patients with coronary heart disease. N Engl J Med. 1975 Jan 30;292(5):224–229. doi: 10.1056/NEJM197501302920502. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES