Rationale and Design of the Multicenter Catheter Ablation of Ventricular Tachycardia Before Transcatheter Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Study.

Document Type

Article

Publication Date

10-1-2023

Publication Title

The American journal of cardiology

Keywords

washington; spokane; catheter ablation; implantable cardioverter defibrillator; sudden cardiac death; tetralogy of Fallot; transcatheter pulmonary valve; ventricular tachycardia; Humans; Tetralogy of Fallot; Pulmonary Valve; Tachycardia, Ventricular; Arrhythmias, Cardiac; Pulmonary Valve Insufficiency; Treatment Outcome; Catheter Ablation; Heart Valve Prosthesis Implantation

Abstract

Patients with repaired tetralogy of Fallot are at elevated risk for ventricular arrhythmia and sudden cardiac death. Over the past decade, the pathogenesis and natural history of ventricular tachycardia has become increasingly understood, and catheter ablation has emerged as an effective treatment modality. Concurrently, there has been great progress in the development of a versatile array of transcatheter valves that can be placed in the native right ventricular outflow tract for the treatment of long-standing pulmonary regurgitation. Although such valve platforms may eliminate the need for repeat cardiac operations, they may also impede catheter access to the myocardial substrates responsible for sustained macro-reentrant ventricular tachycardia. This manuscript provides the rationale and design of a recently devised multicenter study that will examine the clinical outcomes of a uniform, preemptive strategy to eliminate ventricular tachycardia substrates before transcatheter pulmonary valve implantation in patients with tetralogy of Fallot.

Clinical Institute

Cardiovascular (Heart)

Clinical Institute

Women & Children

Department

Cardiology

Department

Pulmonary Medicine

Department

Pediatrics

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