Gabriele Bronzetti, Maurizio Brighenti, Marco Bonvicini
Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Bologna, Italy.
Mini Rev Med Chem. 2018;18(6):490-494. doi: 10.2174/1389557517666170707101411.
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease, with a familial recurrence risk of 3%. Despite performing an optimal surgical repair, TOF patients may feature a poor medium and long-term survival rate: atrial re-entrant tachycardia will develop in more than 30% of patients and high-grade ventricular arrhythmias will be seen in about 10% of patients. These life-threatening arrhythmias and consequent sudden death continue to represent serious complications following TOF repair. Radiofrequency ablation and implantable cardioverter defibrillator are today the most effective therapeutic tools in these subjects, while the administration of antiarrhythmic drugs (Ib agents, beta blockers, and amiodarone), widely prescribed in the past, is now limited to few conditions. However pharmacological therapy still plays a role in the management of those patients who are resistant to the above stated invasive electrophysiological treatments.
法洛四联症（TOF）是最常见的青紫型先天性心脏病，家族复发风险为3%。尽管进行了最佳的手术修复，但TOF患者的中长期生存率可能较低：超过30%的患者会发生房性折返性心动过速，约10%的患者会出现高级别室性心律失常。这些危及生命的心律失常及随之而来的猝死仍是TOF修复术后的严重并发症。射频消融和植入式心脏复律除颤器是目前治疗这些患者最有效的工具，而过去广泛使用的抗心律失常药物（I b类药物、β受体阻滞剂和胺碘酮）现在仅适用于少数情况。然而，药物治疗在那些对上述侵入性电生理治疗耐药的患者管理中仍发挥着作用。
