QRS Prolongation is Associated With Inducible Ventricular Tachycardia After Repair of Tetralogy of Fallot
Section snippets
Patients
Between January 1984 and the end of 1995, 135 unselected patients (81 men and 54 women) with repaired tetralogy of Fallot underwent evaluation (including electrophysiologic studies) at our institution. Their age at surgery was 34 days to 37 years (mean ± SD 3.7 ± 3.9 years, median 2.5). Of the 135, 85 underwent operation at our institution and the rest, elsewhere. Cardiac evaluation included electrocardiogram, echocardiography, cardiac catheterization and electrophysiologic study. Their ages at
Results
All but 1 patient had undergone transventricular repair of tetralogy of Fallot. A transannular patch was used in 56 (41%), a right ventricular outflow patch in 36 (27%), a valved conduit or homograft between right ventricle and pulmonary trunk in 23 patients (17%), and none of the above techniques in the other 20. Pulmonary artery reconstruction was performed in 32 (24%). Before repair, 46 patients (34%) had undergone palliative operations. Reoperations were performed in 13 (10%) and consisted
Discussion
Sudden death is a major concern after repair of congenital heart disease. Tetralogy of Fallot has long been considered a benchmark lesion in this regard. The terminal event causing sudden death is presumably ventricular arrhythmia.1, 2, 3, 4, 5 Gatzoulis et al[6] recently suggested that QRS prolongation can predict ventricular arrhythmia and sudden death. They concluded that “the use of electrophysiologic study in this group (with prolonged QRS duration) may be able to further identify a
Acknowledgements
We wish to thank Xiaobu Ye for statistical help and Barbara Roberts for secretarial assistance.
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