Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

Bessière, Francis; Gardey, Kévin; Bouzeman, Abdeslam; Duthoit, Guillaume; Koutbi, Linda; Labreuche, Julien; Marquié, Christelle; Gourraud, Jean‐Baptiste; Mondoly, Pierre; Sellal, Jean Marc; Bordachar, Pierre; Hermida, Alexis; Anselme, F.; Asselin, Anouk; Audinet, Caroline; Bernard, Yvette; Bovéda, Serge; Chevalier, Philippe; Clerici, G; Costa, Antoine Da; Guillebon, Maxime De; Defaye, Pascal; Eschalier, Romain; Garcia, Rodrigue; Guenancia, Charles; Guy-Moyat, Benoît; Hénaine, Roland; Irles, Didier; Iserin, Laurence; Jourda, François; Ladouceur, Magalie; Lagrange, Philippe; Laredo, Mikaël; Mansourati, Jacques; Massoulié, Grégoire; Mathiron, Amel; Nguyen, Cédric; Ninni, Sandro; Perier, Marie‐Cécile; Pierre, Bertrand; Sacher, Frédéric; Walton, Camille; Winum, Pierre; Martins, Raphaël P.; Pasquié, Jean Luc; Thambo, Jean Benoît; Jouven, Xavier; Combes, Nicolas; Filippo, Sylvie Di; Marijon, Éloi; Waldmann, Victor

doi:10.1016/j.jacep.2021.02.022

Cited by 18 publications

(12 citation statements)

References 30 publications

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“…The right ventricular end-diastolic volume index was greater in the SPVR group (184 mL/m 2 [163-230]) than in the TPVR group (165 mL/m 2 [136-190]; P ¼ .001). The maximum PV landing zone diameter measured by balloon sizing (Figure 1) was 24 mm (20-26.5) in the TPVR group and 30 mm (26)(27)(28)(29)(30)(31)(32)(33) in the SPVR group (P < .001) (Table 2). Excluding patients with RVOT conduit, the median size of the PV landing zone in patients with RVOT was 26 mm (24-28) in the 43 patients who underwent TPVR and 31 mm (28)(29)(30)(31)(32)(33)(34) in the 101 patients who underwent SPVR (P < 0.001) (Table 2).…”

Section: Resultsmentioning

confidence: 98%

“…The maximum PV landing zone diameter measured by balloon sizing (Figure 1) was 24 mm (20-26.5) in the TPVR group and 30 mm (26)(27)(28)(29)(30)(31)(32)(33) in the SPVR group (P < .001) (Table 2). Excluding patients with RVOT conduit, the median size of the PV landing zone in patients with RVOT was 26 mm (24-28) in the 43 patients who underwent TPVR and 31 mm (28)(29)(30)(31)(32)(33)(34) in the 101 patients who underwent SPVR (P < 0.001) (Table 2). The sizes and types of implants of PV are given in Table 3.…”

Section: Resultsmentioning

confidence: 98%

“…A recent study reported that PVR reduced the burden of appropriate implantable cardioverter-defibrillator shock. 31 If the regression in QRS duration reflects a certain degree of risk reduction for ventricular arrhythmia, it is likely that this effect was more attenuated in the TPVR group than in the SPVR group. It is also likely that the longer QRS duration with less regression at the 2-year follow-up may have resulted from larger RV volume and redo-ventriculotomy with an incision in the RV or RVOT in the SPVR group.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of Transcatheter Pulmonary Valve Replacement and Surgical Pulmonary Valve Replacement: A Cohort Analysis

Durongpisitkul¹,

Dangrungroj²,

Chungsomprasong³

et al. 2022

Journal of the Society for Cardiovascular Angiography & Int

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes of Transcatheter Pulmonary Valve Replacement and Surgical Pulmonary Valve Replacement: A Cohort Analysis

Durongpisitkul¹,

Dangrungroj²,

Chungsomprasong³

et al. 2022

Journal of the Society for Cardiovascular Angiography & Int

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“…While optimal indications and timing for PVR remain uncertain in asymptomatic patients, it remains to be determined whether earlier interventions based on the pulmonary annular size may be associated with a lower risk of subsequent VAs. 23 It may also be prudent to avoid large ventriculotomies that transect the pulmonary annulus and increase the diameter of the right ventricular outflow tract during the initial repair to reduce the long-term risk for VAs.…”

Section: Discussionmentioning

confidence: 99%

Systematic Electrophysiological Study Prior to Pulmonary Valve Replacement in Tetralogy of Fallot: A Prospective Multicenter Study

Waldmann

Bessière

Gardey

et al. 2023

Circ: Arrhythmia and Electrophysiology

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BACKGROUND: Ventricular arrhythmias and sudden death are recognized complications in tetralogy of Fallot. Electrophysiological studies (EPS) before pulmonary valve replacement (PVR), the most common reintervention in tetralogy of Fallot, could potentially inform therapy to improve arrhythmic outcomes. METHODS: A prospective multicenter study was conducted to systematically assess EPS with programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR from January 2020 to December 2021. A standardized stimulation protocol was used across all centers. RESULTS: A total of 120 patients were enrolled, mean age 39.2±14.5 years, 53.3% males. Sustained ventricular tachycardia was induced in 27 (22.5%) patients. When identifiable, the critical isthmus most commonly implicated (ie, in 90.0%) was between the ventricular septal defect patch and pulmonary annulus. Factors independently associated with inducible ventricular tachycardia were history of atrial arrhythmia (OR, 8.56 [95% CI, 2.43–34.73]) and pulmonary annulus diameter >26 mm (OR, 5.05 [95% CI, 1.47–21.69]). The EPS led to a substantial change in management in 23 (19.2%) cases: 18 (15.0%) had catheter ablation, 3 (2.5%) surgical cryoablation during PVR, and 9 (7.5%) defibrillator implantation. Repeat EPS 5.1 (4.8–6.2) months after PVR was negative in 8 of 9 (88.9%) patients. No patient experienced a sustained ventricular arrhythmia during 13 (6.1–20.1) months of follow-up. CONCLUSIONS: Systematically performing programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR yields a high rate of inducible ventricular tachycardia and carries the potential to alter management. It remains to be determined whether a standardized treatment approach based on the results of EPS will translate into improved outcomes. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04205461

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“…Chronic RV overload and stretching also result in progressive myocardial re modeling and fibrosis development associated with a greater risk of ventricular arrhyth mias [63]. As recent data suggested that hemodynamic optimization provided by pulmo nary valve replacement may be associated with a decrease in ventricular arrhythmias bur den in this population [64], substrate-based catheter ablation during systematic electro physiology study in this clinical situation may further reduce the long-term arrhythmi risk in these patients. The precise evaluation of structural abnormalities with a significan hemodynamic effect that may constitute reversible causes of arrhythmias is of particula importance, and recent advances in imaging, especially magnetic resonance imaging, may help guide decisions regarding optimal timing and indications for reinterventions [61].…”

Section: Perioperative Evaluation Of Arrhythmiasmentioning

confidence: 99%

Tachyarrhythmias in Congenital Heart Diseases: From Ion Channels to Catheter Ablation

Waldmann

Guichard

Marijon

et al. 2022

JCDD

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Major advances in pediatric cardiology in recent decades, especially surgical techniques, have resulted in an increasing number of patients with congenital heart disease (CHD) surviving to adulthood. This has generated new challenges, particularly with regards to the late onset of complex arrhythmias. Abnormal anatomy, surgical scarring, chronic hypoxemia, hemodynamic compromise, neuro-hormonal abnormalities, and genetic factors can all contribute to creating a unique substrate for arrhythmia development. This review attempts to synthesize the current state of knowledge spanning the spectrum from underlying mechanisms of arrhythmias in patients with congenital heart disease to current ablative strategies. We discuss existing knowledge gaps and highlight important areas for future research.

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Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

Cited by 18 publications

References 30 publications

Outcomes of Transcatheter Pulmonary Valve Replacement and Surgical Pulmonary Valve Replacement: A Cohort Analysis

Outcomes of Transcatheter Pulmonary Valve Replacement and Surgical Pulmonary Valve Replacement: A Cohort Analysis

Systematic Electrophysiological Study Prior to Pulmonary Valve Replacement in Tetralogy of Fallot: A Prospective Multicenter Study

Tachyarrhythmias in Congenital Heart Diseases: From Ion Channels to Catheter Ablation

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