RT-197
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Inhomogeneous prolongation of
ventricular repolarization in young patients with repaired tetralogy of Fallot. Evidence
of electrical myocardial instability?
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Berardo Sarubbi, Giuseppe
Pacileo, Valentino Ducceschi, Carlo Pisacane, Carola Iacono, Maria Giovanna Russo, Lucio
Santangelo*, Aldo Iacono*, Raffaele Calabro.
Second University of Naples, *Chair of Cardiology, Paediatric Cardiology, Monaldi
Hospital, Naples, Italy
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Introduction
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Clinical evidences suggest that in patients followed
up for many years after surgical repair of tetralogy of Fallot an increased incidence of
ventricular arrhythmias and sudden death are more common with older age at follow-up and
older age at operation1-4 and are associated with
residual abnormal right ventricular hemodynamics, such as elevated right ventricular
systolic or end-diastolic pressure2,4,5, with the
presence of a scar in the right ventricle1, a reduced
left ventricular function5, or with the severity of
pulmonary regurgitation6. However, the nature and the
cause of the arrhythmias causing sudden death in such patients are far to be really
understood.
The aim of the present study was to examine ventricular repolarization time indexes,
in terms of both absolute measures and dispersion across the myocardium, in young patients
operated on for tetralogy of Fallot, as these electrocardiographic parameters have been
shown to be effective in the identification of electrical myocardial instability and hence
of risk for either arrhythmia or myocardial stretch following impaired ventricular
function7-12. Finally, the possible influence on
ventricular recovery of known negative prognostic factors, such as late repair (after 2
years of life), pulmonary regurgitation, residual pulmonary obstruction, aorta-pulmonary
shunts prior to perform total correction and transventricular surgical approach have been
investigated too.
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