Rapid ventricular tachycardia in patients with tetralogy of Fallot and implantable cardioverter-defibrillator : Insights from the DAI-T4F nationwide registry
Copyright © 2022 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
BACKGROUND: In repaired tetralogy of Fallot (TOF), little is known about characteristics of patients with rapid ventricular tachycardia (VT). Also, whether patients with a first episode of nonrapid VT may subsequently develop rapid VT or ventricular fibrillation (VF) has not been addressed.
OBJECTIVES: The objectives of this study were to compare patients with rapid VT/VF with those with nonrapid VT and to assess the evolution of VT cycle lengths (VTCLs) overtime.
METHODS: Data were analyzed from a nationwide registry including all patients with TOF and implantable cardioverter-defibrillator (ICD) since 2000. Patients with ≥1 VT episode with VTCL ≤250 ms (240 beats/min) formed the rapid VT/VF group.
RESULTS: Of 144 patients (mean age 42.0 ± 12.7 years; 104 [72%] men), 61 (42%) had at least 1 VT/VF episode, including 28 patients with rapid VT/VF (46%), during a median follow-up of 6.3 years (interquartile range 2.2-10.3 years). Compared with patients in the nonrapid VT group, those in the rapid VT/VF group were significantly younger at ICD implantation (35.2 ± 12.6 years vs 41.5 ± 11.2 years; P = .04), had more frequently a history of cardiac arrest (8 [29%] vs 2 [6%]; P = .02), less frequently a history of atrial arrhythmia (11 [42%] vs 22 [69%]; P = .004), and higher right ventricular ejection fraction (43.3% ± 10.3% vs 36.6% ± 11.2%; P = .04). The median VTCL of VT/VF episodes was 325 ms (interquartile range 235-429 ms). None of the patients with a first documented nonrapid VT episode had rapid VT/VF during follow-up.
CONCLUSION: Patients with TOF and rapid VT/VF had distinct clinical characteristics. The relatively low variation of VTCL over time suggests a room for catheter ablation without a backup ICD in selected patients with well-tolerated VT.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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| Enthalten in: |
Heart rhythm - 20(2023), 2 vom: 01. Feb., Seite 252-260 |
| Sprache: |
Englisch |
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| Links: |
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| Anmerkungen: |
Date Completed 03.02.2023 Date Revised 23.02.2023 published: Print-Electronic ClinicalTrials.gov: NCT03837574 Citation Status MEDLINE |
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| doi: |
10.1016/j.hrthm.2022.10.016 |
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| PPN (Katalog-ID): |
NLM348234341 |
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| 245 | 1 | 0 | |a Rapid ventricular tachycardia in patients with tetralogy of Fallot and implantable cardioverter-defibrillator |b Insights from the DAI-T4F nationwide registry |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 03.02.2023 | ||
| 500 | |a Date Revised 23.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT03837574 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: In repaired tetralogy of Fallot (TOF), little is known about characteristics of patients with rapid ventricular tachycardia (VT). Also, whether patients with a first episode of nonrapid VT may subsequently develop rapid VT or ventricular fibrillation (VF) has not been addressed | ||
| 520 | |a OBJECTIVES: The objectives of this study were to compare patients with rapid VT/VF with those with nonrapid VT and to assess the evolution of VT cycle lengths (VTCLs) overtime | ||
| 520 | |a METHODS: Data were analyzed from a nationwide registry including all patients with TOF and implantable cardioverter-defibrillator (ICD) since 2000. Patients with ≥1 VT episode with VTCL ≤250 ms (240 beats/min) formed the rapid VT/VF group | ||
| 520 | |a RESULTS: Of 144 patients (mean age 42.0 ± 12.7 years; 104 [72%] men), 61 (42%) had at least 1 VT/VF episode, including 28 patients with rapid VT/VF (46%), during a median follow-up of 6.3 years (interquartile range 2.2-10.3 years). Compared with patients in the nonrapid VT group, those in the rapid VT/VF group were significantly younger at ICD implantation (35.2 ± 12.6 years vs 41.5 ± 11.2 years; P = .04), had more frequently a history of cardiac arrest (8 [29%] vs 2 [6%]; P = .02), less frequently a history of atrial arrhythmia (11 [42%] vs 22 [69%]; P = .004), and higher right ventricular ejection fraction (43.3% ± 10.3% vs 36.6% ± 11.2%; P = .04). The median VTCL of VT/VF episodes was 325 ms (interquartile range 235-429 ms). None of the patients with a first documented nonrapid VT episode had rapid VT/VF during follow-up | ||
| 520 | |a CONCLUSION: Patients with TOF and rapid VT/VF had distinct clinical characteristics. The relatively low variation of VTCL over time suggests a room for catheter ablation without a backup ICD in selected patients with well-tolerated VT | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Adult congenital heart disease | |
| 650 | 4 | |a Implantable cardioverter-defibrillator | |
| 650 | 4 | |a Rapid ventricular tachycardia | |
| 650 | 4 | |a Sudden cardiac death | |
| 650 | 4 | |a Tetralogy of Fallot | |
| 650 | 4 | |a Ventricular arrhythmia | |
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| 700 | 1 | |a Pasquié, Jean Luc |e verfasserin |4 aut | |
| 700 | 1 | |a Pierre, Bertrand |e verfasserin |4 aut | |
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