[Sustained ventricular tachycardia 7 years after complete correction of tetralogy of Fallot]

The authors report a case of sustained ventricular tachycardia which occurred seven years after complete surgical correction of Fallot's tetralogy in a 13 year old girl. This arrhythmia was well tolerated haemodynamically, showed right-sided delay and was associated with mitral valve prolapse. After reviewing the literature, several physiopathological mechanisms are discussed: --the role of residual intraventricular conduction defects in sustaining the tachycardia; --the role of the ventriculotomy scar or of other associated lesions (mitral valve prolapse in this case) in the genesis of ventricular extrasystoles; --the postoperative haemodynamic status in the tolerance of the arrhythmias. This is a rare complication with an incidence of less than 2% of survivors followed-up over long periods. There is a risk of sudden death in 38% of these patients with ventricular arrhythmias which justifies Holter monitoring and ECG stress testing for their detection.