Restrictive physiology in tetralogy of Fallot: exercise and arrhythmogenesis.
The effect of right ventricular restrictive physiology on exercise capacity and arrhythmogenesis after correction of tetralogy of Fallot was assessed in 80 patients aged 7.9 +/- 3.6 years. Right ventricular restrictive physiology was defined as the presence of an A wave across the pulmonary artery on 2-dimensional echocardiography. At the 6 month follow-up, 52 patients had restrictive physiology (group 1). A transannular patch was used in 36 patients in group 1 (62%) and in 19 (86%) of the 28 patients without restrictive physiology (group 2). Maximum heart rate attained (69% vs. 77%), maximum predicted heart rate (211 +/- 12.6 vs. 226 +/- 24.2 beats x min(-1)), and metabolic equivalents (7.6 +/- 3.2 vs. 8.1 +/- 2.6) were higher in group 2, but not significantly. The chronotropic index was similar in both groups. In group 1, 14% of patients presented with ventricular premature complexes at 6 months. No effect on exercise capacity and arrhythmogenesis could be attributed to restrictive physiology, but both groups had chronotropic incompetence compared to normal children.
Rathore
Kaushalendra S
KS
Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. kaushalendra_rathore@hotmail.com
Agrawal
Surendra K
SK
Kapoor
Aditya
A
D000293:Adolescent; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013771:Tetralogy of Fallot / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D016278:Ventricular Function, Right