Maury Philippe, Sacher Frederic, Rollin Anne, Mondoly Pierre, Duparc Alexandre, Zeppenfeld Katja, Hascoet Sebastien
University Hospital Rangueil, 31059 Toulouse cedex 09, France; Unité Inserm U1048, Toulouse, France.
Inserm 1045, LIRYC Institute, Bordeaux University Hospital, Bordeaux, France.
Arch Cardiovasc Dis. 2017 May;110(5):354-362. doi: 10.1016/j.acvd.2016.12.006. Epub 2017 Feb 17.
Malignant ventricular arrhythmias and sudden cardiac death may late happen in repaired tetralogy of Fallot, although probably less frequently than previously thought, especially with the advent of new surgical techniques/management. Ventricular tachycardias are caused by reentry around the surgical scars/patches and valves. Many predictive factors have been proposed, which suffer from poor accuracy. There is currently no recommended indication for prophylactic implantable cardioverter defibrillator implantation-except maybe in the case of multiple risk factors-while radiofrequncy ablation may be proposed in secondary prevention with or even without a back-up implantable cardioverter defibrillator in selected cases. Repeated cardiological investigations and monitoring should be proposed for every operated patient.
恶性室性心律失常和心源性猝死可能在法洛四联症修复术后晚期发生，尽管其发生率可能比之前认为的要低，尤其是随着新手术技术/管理方法的出现。室性心动过速是由围绕手术瘢痕/补片和瓣膜的折返引起的。已经提出了许多预测因素，但其准确性较差。目前，除了可能存在多种危险因素的情况外，尚无预防性植入式心脏复律除颤器植入的推荐指征，而在二级预防中，对于某些病例，无论是否有备用植入式心脏复律除颤器，都可考虑进行射频消融。应为每位接受手术的患者进行反复的心脏检查和监测。
