Surgical correction of recurrent sustained ventricular tachycardia following complete repair of tetralogy of Fallot.

Ventricular arrhythmias occur in 0.3% to 3% of patients following complete repair of tetralogy of Fallot. These life-threatening arrhythmias do not appear related to the hemodynamic success of the repair. This report presents the case histories of two patients who experienced from 30 to 150 documented episodes of sustained ventricular tachycardia (VT) following complete repair of tetralogy of Fallot. Pharmacologic and pacing regimens failed to prevent recurrence in both patients. The source of the arrhythmia was localized to the right ventriculotomy scar by electrophysiological mapping. This scar was surgically excised. VT was not inducible following operation and has not recurred in the 6 months and 18 months following discharge of the patients from the hospital. If medical therapy fails, operation combined with extensive preoperative and intraoperative electrophysiological study may be a realistic option in the treatment of selected patients with VT following complete repair of tetralogy of Fallot.