Researchers studied on the impact of pulmonary valve replacement (PVR) on ventricular arrhythmias in a population of tetralogy of Fallot (TOF) patients with continuous cardiac monitoring by implantable cardioverter-defibrillators (ICDs). Data from the DAI-T4F were utilized to study all TOF patients with an ICD since 2000. Survival data with recurrent events were used to compare the burden of appropriate ICD therapies before and after PVR in patients who underwent PVR over the study period.

A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% male) were included from 40 centres. Over a median follow-up period of 6.8 years, 26 patients (15.8%) underwent PVR. Among those patients, 18 (69.2%) experienced at least one appropriate ICD therapy.

When comparing all ICD therapies delivered before (n = 62) and after (n = 16) PVR, the burden of appropriate ICD therapies was significantly lower after PVR (hazard ratio [HR], 0.21; 95% confidence interval [CI], 0.08-0.56; p = 0.002). Respective ICD therapy rates per 100 person-years were 44.0 before and 13.2 after PVR (p < 0.001).

In the overall cohort, PVR before ICD implantation was also independently associated with a lower risk of appropriate ICD therapy in primary prevention patients (HR, 0.29; 95% CI, 0.10-0.89; p = 0.031).

Adults with tetralogy of Fallot (TOF) with implantable cardioverter-defibrillators (ICDs), the burden of appropriate ICD therapies was significantly reduced after pulmonary valve replacement (PVR). PVR prior to ICD placement was independently associated with a lower risk of appropriate ICD therapy in primary prevention patients.

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Source

https://www.acc.org/latest-in-cardiology/journal-scans/2021/10/20/19/23/impact-of-pulmonary-valve-replacement

Tags

Disease Condition ,Therapeutic Modality ,Arrhythmias,Interventional Cardiology,Antidysrhythmic Toxicity,Arrhythmogenic Right Ventricular Dysplasia (ARVD),Atrioventricular Dissociation,Ventricular Fibrillation,Ventricular Premature Complexes,Ventricular Tachycardia,Bare metal stent,Drug Eluting Stent,Percutaneous Coronary Intervention,Trans catheter Therapy