Right ventricular overload and induced sustained ventricular tachycardia in operatively "repaired" tetralogy of Fallot.
The aim of the study was to evaluate the main predictors of the inducibility of sustained ventricular tachycardia (VT) in patients with repaired tetralogy of Fallot. Thirty-five patients (age 12 +/- 6 years) underwent right-sided cardiac catheterization, echocardiography, radionuclide angiography and ventricular stimulation; 10 had (group 1) and 25 had no (group 2) sustained VT. Group 1 patients were significantly older at the time of surgery and had longer follow-up periods (7 +/- 3 vs 4 +/- 4 years, p less than 0.02; and 12 +/- 4 vs 5 +/- 2 years, p less than 0.001, respectively). Right ventricular (RV) systolic pressure, end-systolic and end-diastolic normalized RV volumes were higher in group 1 (48 +/- 14 vs 38 +/- 11 mm Hg, p less than 0.05; 1.23 +/- 0.2 vs 0.86 +/- 0.17, p less than 0.001; and 2.35 +/- 0.37 vs 1.70 +/- 0.22, p less than 0.001, respectively). RV end-diastolic pressure, left ventricular and RV ejection fractions were similar in the 2 groups. A stepwise discriminant analysis was made to predict patients with inducible sustained VT (group 1): Time period from surgery to follow-up (p less than 0.001), normalized RV end-systolic volume (p less than 0.002) and RV systolic pressure (p = 0.01) were higher in group 1 and allowed classification of 90% of patients in group 1 and 96% in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)
Marie
P Y
PY
Department of Cardiology, CHRU Nancy, France.
Marçon
F
F
Brunotte
F
F
Briançon
S
S
Danchin
N
N
Worms
A M
AM
Robert
J
J
Pernot
C
C
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D006328:Cardiac Catheterization; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015635:Radionuclide Ventriculography; D013610:Tachycardia / Q000209:etiology* / Q000503:physiopathology; D013771:Tetralogy of Fallot / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right