Risk stratification of ventricular arrhythmias in repaired tetralogy of Fallot.
INTRODUCTION AND OBJECTIVES
Risk stratification of ventricular arrhythmias in patients with repaired tetralogy of Fallot (rTOF) remains unresolved. We aimed to identify right ventricular (RV) electrophysiological parameters potentially associated with a higher risk of ventricular arrhythmias in patients with rTOF.


METHODS
We included all consecutive patients with rTOF who underwent RV electroanatomical mapping at a single tertiary center. We used logistic regression modeling to identify those variables associated with an increased risk of clinical or induced ventricular tachycardia (VT), or clinical VT exclusively.


RESULTS
Twenty-one of the 56 patients included had clinical or induced VT. A high-frequency of premature ventricular contractions/nonsustained VT (OR, 11.34; 95%CI, 1.50-85.97; P=.019), an HV interval > 55 ms (OR, 21.20; 95%CI, 3.12-144.14; P=.002), and RV activation time (ms) (OR [per 10ms intervals], 1.34; 95%CI, 1.02-1.75; P=.035) proved to be associated with clinical or induced VT. The model including this information had good discrimination ability, with an area under the curve of 0.884 (95%CI, 0.79-0.97; P <.001). When considering only clinical VT as the outcome of interest, only an HV interval > 55ms (OR, 9.65; 95%CI, 1.41-66.14; P=.021) and high-frequency of premature ventricular contractions/nonsustained VT (OR, 13.14; 95%CI, 1.95-88.54; P=.008) were independently associated (area under the curve of 0.836 [95%CI, 0.663-1.000; P=.002]).


CONCLUSIONS
High-frequency of premature ventricular contractions/nonsustained VT, an HV interval> 55ms and RV activation time are factors associated with an increased risk of ventricular arrhythmias in patients with rTOF.
['Rivas-Gándara|Nuria|N|', 'Francisco-Pascual|Jaume|J|', 'Pijuan-Domenech|Antonia|A|', 'Ribera-Solé|Aida|A|', 'Dos-Subirá|Laura|L|', 'Benito|Begoña|B|', 'Terricabras|Maria|M|', 'Pérez-Rodon|Jordi|J|', 'Subirana|María Teresa|MT|', 'Santos-Ortega|Alba|A|', 'Roses-Noguer|Ferran|F|', 'Miranda|Berta|B|', 'Moya-Mitjans|Àngel|À|', 'Ferreira-González|Ignacio|I|']
D006352:Heart Ventricles D006801:Humans D018570:Risk Assessment D017180:Tachycardia, Ventricular D013771:Tetralogy of Fallot D018879:Ventricular Premature Complexes
Arrhythmia Tetralogy of Fallot Ventricular tachycardia Arritmia Cardiopatía congénita Congenital heart disease Mapeo ventricular Muerte súbita cardiaca Sudden cardiac death Taquicardia ventricular Tetralogía de Fallot Ventricular mapping