EP News: Pediatric and Congenital Electrophysiology

  • Martin J. LaPage
    Address reprint requests and correspondence: Dr Martin J. LaPage, Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan, 1540 E Hospital Dr, 11th Floor Ped Card, Ann Arbor, MI 48109.
    Division of Pediatric Cardiology, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
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      Dodeja et al (Pediatr Cardiol February 10, 2023;, PMID 36763139) reported the results of their single-center retrospective study on ventricular arrhythmia (VA)–specific outcomes after transcatheter pulmonary valve replacement (TPVR). The 81 included patients were all older than 18 years and underwent TPVR between 2010 and 2019 at a mean age of 27 ± 13 years. Mean follow-up was 6.4 ± 3 years. VAs occurred in 4 patients (5%). A variety of clinical risk factors were compared between those with VAs and those without, including ventricular function, surgical era, history of ventriculotomy, history of palliative shunt, history of arrhythmia, QRS duration, QRS fragmentation, and left ventricular end-diastolic pressure when available. There was no difference in any risk factors between groups. Patients deemed at a moderate risk of VA events before TPVR underwent an electrophysiology study (EPS) for ventricular stimulation (n = 13), 4 of whom had a positive result. Of the 4 patients with VA events, only 1 underwent an EPS, which was negative. The authors conclude that “current era” risk factors did not differentiate outcomes after TPVR and that an evolving approach to risk assessment will be necessary as disease factors evolve.
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