Ventricular late potentials and spontaneous ventricular arrhythmias after surgical repair of tetralogy of Fallot: do they have prognostic value?

OBJECTIVE To determine the prognostic significance of ventricular late potentials and spontaneous ventricular arrhythmias detected early after surgical repair of tetralogy of Fallot. DESIGN Prospective observational. SETTING Cardiology department of a teaching hospital. METHODS Between June 1984 and June 1991, 104 children (63 boys, 41 girls) were studied by signal averaging and 24 hour ambulatory monitoring after surgical repair of tetralogy of Fallot. Mean (SD) age at operation was 6 (3) years, mean interval between operation and evaluation was 8 (25) months, and the follow up after evaluation was one to 88 (mean 30) months. RESULTS Ventricular late potentials were detected in 24/104 patients (23%) and spontaneous ventricular arrhythmias in 39/96 patients (38%); usually (in 81%) these were unifocal and rare. Patients with ventricular late potentials were older at operation than patients without late potentials (9 (3) v 6 (3) years, P = 0.002). No correlation was found between the presence of ventricular late potentials and the presence or complexity of spontaneous ventricular arrhythmias early after operation. During the mean follow up of 2.5 years no case of sudden death or sustained ventricular tachycardia was found. CONCLUSION Short-term prognosis after surgical repair of tetralogy of Fallot is good; ventricular late potentials and spontaneous ventricular arrhythmias are often detected shortly after operation, but in the medium term follow up they do not predict sudden death or serious ventricular arrhythmias.