Pediatric/Adult Congenital Heart Disease -> Adult Congenital Heart Disease D-AB31 - ACHD and Pediatric EP (ID 29) Abstract

Abstract

Background: Ventricular arrhythmias are a source of mortality in patients with repaired tetralogy of Fallot (rTOF), but risk factors have not been fully described.
Objective: To identify electrophysiological characteristics of the right ventricle myocardium associated with a higher risk of ventricular arrhythmias in patients with rTOF.
Methods: We included all consecutive patients with rTOF who underwent right ventricle electroanatomical mapping at a single tertiary center. We used logistic regression modeling to analyze potential predictors of clinical or induced ventricular tachycardia (VT) and a risk score was derived from the model.
Results: Fifty-six patients were included. A total of 21 patients had clinical (n=11) or inducible (n=10) VT. Predictors of clinical or induced VT were an HV >55 ms (OR 21.20, 95% CI 3.12-144.14, p=0.002), high grade premature ventricular contractions/ non sustained VT (OR 11.34, 95% CI 1.50-85.97, p=0.035), and right ventricle activation time (OR 1.03, 95% CI 1.00-1.06, p= 0.035). A risk score built on these predictors showed an area under the curve of 0.873. Three risk categories could be established: low risk (0-4 points, 41% of patients, risk ≤ 20%); moderate risk (5-10 points, 45% of patients, risk of 20-82%) and high risk (> 10 points 14% of patient, risk >82 %).
Conclusion: High grade premature ventricular contractions/ non sustained VT, an HV interval >55 ms and right ventricle activation time are good predictors of clinical or induced VT in patients with rTOF. A risk score based on these predictors can be useful to identify patients at higher risk of VT.
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