Abstract 15740: Cardiac Magnetic Resonance Imaging Predictors of Ventricular Arrhythmia in Tetralogy of Fallot
Introduction: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart defect. Surgical management has resulted in dramatic improvements in mortality; however, burden of both atrial and ventricular arrhythmia remains an important cause of morbidity and mortality. Cardiac MRI (CMR) is serially performed in this population to determine timing of pulmonary valve replacement.
Hypothesis: We hypothesized that standard volumetric and functional CMR measures are associated with ventricular arrhythmia (VA) in adults with repaired TOF.
Methods: A cohort of adult patients with repaired TOF who underwent CMR between 8/2004 and 8/2015 was identified. CMR measures were recorded and medical records were reviewed for arrhythmia diagnoses including sustained ventricular tachycardia, non-sustained ventricular tachycardia, sudden death, and aborted sudden death. VA was diagnosed by Holter monitor detection of 3 or more beats of ventricular tachycardia or documentation of clinical diagnosis in the medical record. CMR measures were tested for association with the diagnosis of VA using a Mann Whitney-U test.
Results: Of 119 adults with repaired TOF, 57 (48%) had a diagnosis of arrhythmia; 63% of the arrhythmias were ventricular. Age, left ventricular (LV) diastolic volume, LV systolic volume, and LV stroke volume by CMR were significantly associated with VA. Right ventricular volumes and performance were not significantly associated with VA. See table 1 for all parameters that were tested.
Conclusions: In conclusion, both atrial and ventricular arrhythmias are common following repair of tetralogy of Fallot. Age is the strongest predictor of arrhythmia risk. While tetralogy of Fallot is primarily a right heart lesion, LV hemodynamics play a more significant role in ventricular arrhythmia risk. CMR can potentially assist with VA risk prediction.
Author Disclosures: A.J. Weingarten: None. J.H. Soslow: None. L.W. Markham: None.
- © 2016 by American Heart Association, Inc.