title: The role of mechanical-electrical interaction in ventricular arrhythmia: evidence from a novel animal model for repaired tetralogy of Fallot.
abstract: Pulmonary regurgitation and prolonged QRS duration of right bundle branch (RBB) block are common in repaired tetralogy of Fallot (TOF) and increase the risk of sudden death. We sought to establish an animal model to reflect both abnormalities. Twenty-one canines: group I (n = 7) received a surgical right ventricular outflow tract (RVOT) transannular patch plus pulmonary valve destruction; group II (n = 5) received RBB ablation and sham operation; and group III (n = 9) received combined interventions. Serial electrophysiological data were obtained up to 1 y. Procedure mortality was 27.6%. At 1 y, although severe pulmonary regurgitation was documented in most dogs in groups I (71%) and III (100%), progressive RVOT dilatation was noted in group III. RBB block was present in all dogs in groups II and III. However, the increments of QRS duration, QTc, JTc, and QT dispersion progression between 1 mo and 1 y were all greatest in group III. Ventricular arrhythmia events were frequent in group III (median 3.3/mo) but uncommon in groups I and II (median 1/mo). We have created a novel animal model that adequately reflects both the hemodynamic and electrophysiological characteristics of repaired TOF patients and can be applied to examine the risk of ventricular arrhythmias.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei 100, Taiwan, Republic of China.
authors.forename: Shuenn-Nan
authors.initials: SN
authors.lastname: Chiu
authors.forename: Shu-Chien
authors.initials: SC
authors.lastname: Huang
authors.forename: Chi-Wei
authors.initials: CW
authors.lastname: Chang
authors.forename: Yih-Sharng
authors.initials: YS
authors.lastname: Chen
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Chen
authors.forename: Ming-Tai
authors.initials: MT
authors.lastname: Lin
authors.forename: Chun-An
authors.initials: CA
authors.lastname: Chen
authors.forename: Jou-Kou
authors.initials: JK
authors.lastname: Wang
authors.forename: Mei-Hwan
authors.initials: MH
authors.lastname: Wu
mesh_terms: D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D002037:Bundle-Branch Block / Q000209:etiology / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000209:etiology; D004285:Dogs; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D011665:Pulmonary Valve Insufficiency / Q000209:etiology / Q000503:physiopathology; D013771:Tetralogy of Fallot / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*