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Asian Cardiovasc Thorac Ann 2006;14:279-283
© 2006 Asia Publishing EXchange Ltd

ORIGINAL CONTRIBUTIONS

Restrictive Physiology in Tetralogy of Fallot: Exercise and Arrhythmogenesis

Kaushalendra S Rathore, MCh, Surendra K Agrawal, MCh, Aditya Kapoor, DM

Department of Cardiovascular and Thoracic Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India

For reprint information contact: Kaushalendra S Rathore, MCh Tel: 61 2 4314 57784 Fax: 61 2 9588 4129 Email: kaushalendra_rathore{at}hotmail.com, Suite 15, Level 4, St. George Hospital, Sydney, NSW 2217, Australia.

The effect of right ventricular restrictive physiology on exercise capacity and arrhythmogenesis after correction of tetralogy of Fallot was assessed in 80 patients aged 7.9 ± 3.6 years. Right ventricular restrictive physiology was defined as the presence of an A wave across the pulmonary artery on 2-dimensional echocardiography. At the 6 month follow-up, 52 patients had restrictive physiology (group 1). A transannular patch was used in 36 patients in group 1 (62%) and in 19 (86%) of the 28 patients without restrictive physiology (group 2). Maximum heart rate attained (69% vs. 77%), maximum predicted heart rate (211 ± 12.6 vs. 226 ± 24.2 beats·min–1), and metabolic equivalents (7.6 ± 3.2 vs. 8.1 ± 2.6) were higher in group 2, but not significantly. The chronotropic index was similar in both groups. In group 1, 14% of patients presented with ventricular premature complexes at 6 months. No effect on exercise capacity and arrhythmogenesis could be attributed to restrictive physiology, but both groups had chronotropic incompetence compared to normal children.






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