PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of brheartjLink to Publisher's site
 
Br Heart J. 1980 September; 44(3): 248–253.
PMCID: PMC482393

Detection of late arrhythmia and conduction disturbance after correction of tetralogy of Fallot.

Abstract

The electrocardiographic conduction disturbances were evaluated retrospectively, in relation to prognosis, in 196 patients who underwent correction of tetralogy of Fallot. The follow-up was one to 20 years (mean 10). After surgery complete right bundle-branch block occurred in 187 patients (95%), right bundle-branch block and left axis deviation in 17 patients (9%), and progressive conduction defects, either left axis deviation or right bundle-branch block, developed during follow-up in 21 patients (11%). Nine patients (4.6%) died suddenly and two patients developed complete heart block late after the operation. Though late sudden death or complete heart block occurred in 19 per cent of patients with progressive conduction defects as opposed to 4 per cent of the group with stable conduction defects, the difference was not significant. Twenty-four hour ambulatory electrocardiographic monitoring was performed in 74 patients; 41 per cent had significant (Lown grade 2, 3, or 4) ventricular arrhythmias. The incidence of ventricular arrhythmia in the group with progressive conduction defects (80%) was significantly higher than in the group with stable conduction defects (30%). As occult arrhythmia may be the cause of sudden death, it is important to identify these patients.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (853K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Garson A, Jr, Nihill MR, McNamara DG, Cooley DA. Status of the adult and adolescent after repair of tetralogy of Fallot. Circulation. 1979 Jun;59(6):1232–1240. [PubMed]
  • Kulbertus HE, Coyne JJ, Hallidie-Smith KA. Conduction disturbances before and after surgical closure of ventricular septal defect. Am Heart J. 1969 Jan;77(1):123–131. [PubMed]
  • Wolff GS, Rowland TW, Ellison RC. Surgically induced right bundle-branch block with left anterior hemiblock. An ominous sign in postoperative tetralogy of Fallot. Circulation. 1972 Sep;46(3):587–594. [PubMed]
  • Cairns JA, Dobell AR, Gibbons JE, Tessler I. Prognosis of right bundle branch block and left anterior hemiblock after intracardiac repair of tetralogy of Fallot. Am Heart J. 1975 Nov;90(5):549–554. [PubMed]
  • Downing JW, Jr, Kaplan S, Bove KE. Postsurgical left anterior hemiblock and right bundle-branch block. Br Heart J. 1972 Mar;34(3):263–270. [PMC free article] [PubMed]
  • Gillette PC, Yeoman MA, Mullins CE, McNamara DG. Sudden death after repair of tetralogy of Fallot. Electrocardiographic and electrophysiologic abnormalities. Circulation. 1977 Oct;56(4 Pt 1):566–571. [PubMed]
  • Quattlebaum TG, Varghese J, Neill CA, Donahoo JS. Sudden death among postoperative patients with tetralogy of Fallot: a follow-up study of 243 patients for an average of twelve years. Circulation. 1976 Aug;54(2):289–293. [PubMed]
  • James FW, Kaplan S, Chou TC. Unexpected cardiac arrest in patients after surgical correction of tetralogy of Fallot. Circulation. 1975 Oct;52(4):691–695. [PubMed]
  • Ryan M, Lown B, Horn H. Comparison of ventricular ectopic activity during 24-hour monitoring and exercise testing in patients with coronary heart disease. N Engl J Med. 1975 Jan 30;292(5):224–229. [PubMed]
  • Steeg CN, Krongrad E, Davachi F, Bowman FO, Jr, Malm JR, Gersony WM. Postoperative left anterior hemiblock and right bundle branch block following repair of tetralogy of Fallot. Clinical and etiologic considerations. Circulation. 1975 Jun;51(6):1026–1029. [PubMed]
  • TITUS JL, DAUGHERTY GW, KIRKLIN JW, EDWARDS JE. Lesions of the atrioventricular conduction system after repair of ventricular septal defect. Relation to heart block. Circulation. 1963 Jul;28:82–88. [PubMed]
  • Gelband H, Waldo AL, Kaiser GA, Bowman FO, Jr, Malm JR, Hoffman BF. Etiology of right bundle-branch block in patients undergoing total correction of tetralogy of Fallot. Circulation. 1971 Dec;44(6):1022–1033. [PubMed]
  • Horowitz LN, Simson MB, Spear JF, Josephson ME, Moore EN, Alexander JA, Kastor JA, Edmunds LH., Jr The mechanism of apparent right bundle branch block after transatrial repair of tetralogy of Fallot. Circulation. 1979 Jun;59(6):1241–1252. [PubMed]
  • Watt TB, Jr, Pruitt RD. Focal lesions in the canine bundle of His. Their effect on ventricular excitation. Circ Res. 1972 Oct;31(4):531–545. [PubMed]
  • Moss AJ, Klyman G, Emmanouilides GC. Late onset complete heart block. Newly recognized sequela of cardiac surgery. Am J Cardiol. 1972 Dec;30(8):884–887. [PubMed]
  • Brodsky M, Wu D, Denes P, Kanakis C, Rosen KM. Arrhythmias documented by 24 hour continuous electrocardiographic monitoring in 50 male medical students without apparent heart disease. Am J Cardiol. 1977 Mar;39(3):390–395. [PubMed]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group