Arrhythmia Susceptibility and Management in Adult Patients with Repaired Tetralogy of Fallot

Abstract

Tetralogy of Fallot is the most common cyanotic congenital valvular heart lesion. Successful neonatal repair has lead to improved survival into and through adulthood. Severe pulmonary regurgitation occurs as a consequence of surgical repair, resulting in right ventricular volume overload, tricuspid regurgitation, and atrial and ventricular scarring and fibrosis. Repair also involves atriotomy and ventriculotomy, as well as the placement of patch material. These interventions contribute to an increased arrhythmia burden in these patients. Management strategies are variably successful and include pharmacotherapy, catheter ablation, device implantation, and pulmonary valve replacement.