Electrophysiological follow-up of tetralogy of fallot

Arrhythmias and sudden death are well-recognized complications that occur l ate after correction of tetralogy of Fallot. This study, based on the liter ature and personal work, reviews the numerous investigations prompted by th ese complications and provides recommendations regarding follow-up. Conduct ion disturbances and ventricular arrhythmias are both common; although most ly asymptomatic, they are the likely cause of syncopy and sudden death. Sup raventricular arrhythmias are less common but cause symptoms more frequentl y. Detecting patients at risk for life-threatening arrhythmias is an import ant task. The simple surface electrocardiogram (ECG) gives a host of inform ation regarding patients at risk. Holter recordings, signal-averaged EGG, a nd invasive electrophysiological studies may all be helpful; the indication s to perform these investigations are discussed and propositions are made f or the follow-up of the postoperative patient. There is hope that a systema tic approach along these lines, together with surgery done at an earlier ag e, will decrease the incidence of severe arrhythmias and sudden death in th e future.