Right ventricle anatomy can predict new onset ventricular tachycardia in patients with repaired tetralogy of Fallot

Results Nine patients had ventricular tachyarrhythmia (6%) during follow-up. Patients who developed ventricular tachyarrhythmia were older (42.5 [34.9-50.2] vs. 29 [21-40] years; p=0.01), had a later repair (12.8 [6.2-13.9] vs. 4.4 [2-8] years; p=0.02), larger akinetic right ventricular outflow track (RVOT) region (Figure ) (length 55 [34-60] vs. 30 [20-40] mm; p=0.002) and a lower RV ejection fraction (42 [40-52] vs. 53 [51-55] %; p=0.01), compared to the other patients. On univariate Cox analysis, RVOT akinetic region length and RV ejection fraction were predictive of ventricular tachyarrhythmia. On stepwise Cox regression analysis, the RVOT akinetic region length was the only remaining predictor (Hazard ratio 1.05, 95% Confidence Interval 1.01-1.08 per mm; p=0.004). The survival ROC curve analysis indicated a cut-off value of 30mm as a predictor of VA during 6 year follow-up with an AUC of 0.77, sensitivity of 83% and specificity of 61%. RVOT akinetic area length >30mm predicted reduced VA-free survival (Logrank p=0.002).