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Arrhythmias in Congenital Heart Disease: Tetralogy of Fallot
Shankar Baskar1, Aarti S Dalal2
1The Heart Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
Abstract:
Tetralogy of Fallot is the most common cyanotic congenital heart disease, characterized by 4 defects: pulmonary outflow obstruction, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Advances in surgical repair have significantly improved survival, but patients remain at risk for long-term complications, especially arrhythmias. Immediate postoperative arrhythmias include junctional ectopic tachycardia, complete heart block, while long-term atrial tachycardias, and life-threatening ventricular tachycardias occur linked to scar-related reentry circuits. Modern management includes antiarrhythmic medications, catheter ablation, and implantable cardioverted defibrillators, with newer strategies focusing on identifying and ablating slow-conducting anatomical isthmuses for ventricular tachycardia.
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