Rationale and Design of the Multicenter Catheter Ablation of Ventricular Tachycardia Before Transcatheter Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Study

Patients with repaired tetralogy of Fallot are at elevated risk for ventricular arrhythmia and sudden cardiac death. Over the past decade, the pathogenesis and natural history of ventricular tachycardia has become increasingly understood, and catheter ablation has emerged as an effective treatment m...

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Bibliographic Details
Published in:The American journal of cardiology 2023-10, Vol.204, p.14-21
Main Authors: Moore, Jeremy P., Aboulhosn, Jamil A., Zeppenfeld, Katja, Waldmann, Victor, Bessière, Francis, Blom, Nico A., Combes, Nicolas, Fish, Frank A., McLeod, Christopher J., Kanter, Ronald J., Tan, Weiyi, Patel, Nimesh, von Alvensleben, Johannes C., Kamp, Anna, Lloyd, Michael S., Anderson, Charles C., Tan, Reina B., Mariucci, Elisabetta, Levi, Daniel S., Salem, Morris, Shivkumar, Kalyanam, Khairy, Paul
Format: Article
Language:English
Subjects:
Ablation
Arrhythmia
Cardiac arrhythmia
Cardiovascular disease
catheter ablation
Catheters
Congenital diseases
Design
Energy resources
Heart
implantable cardioverter defibrillator
Life Sciences
Medical instruments
Pathogenesis
Patients
Pediatrics
Preempting
Radiofrequency ablation
Regurgitation
Substrates
sudden cardiac death
Tachycardia
Tetralogy of Fallot
transcatheter pulmonary valve
Ventricle
ventricular tachycardia
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Summary:Patients with repaired tetralogy of Fallot are at elevated risk for ventricular arrhythmia and sudden cardiac death. Over the past decade, the pathogenesis and natural history of ventricular tachycardia has become increasingly understood, and catheter ablation has emerged as an effective treatment modality. Concurrently, there has been great progress in the development of a versatile array of transcatheter valves that can be placed in the native right ventricular outflow tract for the treatment of long-standing pulmonary regurgitation. Although such valve platforms may eliminate the need for repeat cardiac operations, they may also impede catheter access to the myocardial substrates responsible for sustained macro-reentrant ventricular tachycardia. This manuscript provides the rationale and design of a recently devised multicenter study that will examine the clinical outcomes of a uniform, preemptive strategy to eliminate ventricular tachycardia substrates before transcatheter pulmonary valve implantation in patients with tetralogy of Fallot.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2023.07.087