title: Long-Term Efficacy of Implantable Cardioverter Defibrillator in Repaired Tetralogy of Fallot　- Role of Anti-tachycardia Pacing.
abstract: Tetralogy of Fallot (TOF) is one of the common congenital heart diseases (CHD) in implantable cardioverter defibrillator (ICD) recipients, but few studies have reported the long-term outcomes of and the anti-tachycardia pacing (ATP) efficacy in repaired TOF.
  
  
  
  Twenty-one repaired TOF patients with an ICD implanted between April 2003 and March 2015 were investigated retrospectively. ICD therapy and clinical outcome were analyzed. Mean patient age was 39±11 years; 62% were male; and mean age at repair surgery was 9.4±6.8 years. During a median follow-up of 5.6 years (range, 2.6-8.4 years), no patients died. Appropriate ATP were delivered in 11 patients (52%), with appropriate shocks in 5 patients (24%) and inappropriate shocks in 5 patients (24%). The success rate of ATP was 98% for fast ventricular tachycardia (VT; cycle length ≤320 ms) and 98% for slow VT (cycle length >320 ms). ATP effectiveness increased from 81.5% with the first ATP attempt to 93.7% with the second ATP attempt, to 97.5% with the third ATP attempt, and to 98.6% with the fourth or successive ATP attempt (P<0.0001, Cochran-Armitage trend test).
  
  
  
  ATP was highly effective in repaired TOF regardless of VT cycle length. Multiple ATP attempts could have an important role in VT termination, and the novel subcutaneous ICD without ATP capability should be used carefully.
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Henmi
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ejima
authors.forename: Daigo
authors.initials: D
authors.lastname: Yagishita
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iwanami
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Daiji
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Keiko
authors.initials: K
authors.lastname: Toyohara
authors.forename: Morio
authors.initials: M
authors.lastname: Shoda
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D000255:Adenosine Triphosphate / Q000627:therapeutic use; D000328:Adult; D002304:Cardiac Pacing, Artificial; D016022:Case-Control Studies; D017147:Defibrillators, Implantable / Q000592:standards*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000503:physiopathology; D013771:Tetralogy of Fallot / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000255:Adenosine Triphosphate