Atrial arrhythmias in adults after repair of tetralogy of Fallot.

Abstract

Because sudden death has been an important concern in patients who have undergone intracardiac repair of Fallot’s tetralogy, electrophysiological interest has understandably focused on high-degree heart block and ventricular arrhythmias. High-degree heart block has yielded to ventricular tachycardia as the probable cause of sudden death. By reason of the attention devoted to ventricular electrical instability, comparatively little attention has been paid to disturbances in atrial rhythm. The timely study from the Adult Congenital Heart Disease Clinic of the Thorax Center, Rotterdam, addressed this important deficiency and put into perspective the incidence and significance of atrial arrhythmias in adults after repair of Fallot’s tetralogy. The relatively early era of cardiac surgery reflected in the report was a necessity, not a shortcoming, because the data were derived from an adult patient population after a mean follow-up of 17.5 years (1.4 to 32 years). The observations are therefore based on a wide variety of surgical techniques, a relatively broad age range at time of operation, and a substantial follow-up. Significantly, the surgical and follow-up data were derived entirely from …