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Little is known about the potential for more serious ventricular arrhythmias (VA) in children who undergo PPVI. We sought to evaluate the incidence of severe VA following PPVI in a pediatric population and to explore potential predictive factors. A retrospective cohort study was conducted of patients who underwent PPVI under 20\u00a0years of age in our institution from January 2007 to December 2019. The primary outcome of severe VA was defined as sustained and\/or hemodynamically unstable ventricular tachycardia (VT), inducible sustained VT, or sudden death of presumed arrhythmic etiology. A total of 21 patients (mean age\u00a016.2\u2009\u00b1\u20092.1\u00a0years; 66.7% male) underwent PPVI. The majority of patients (<jats:italic>N<\/jats:italic>\u2009=\u200915; 71.4%) had tetralogy of Fallot (TOF) or TOF-like physiology, with the most common indication being pulmonary insufficiency (<jats:italic>N<\/jats:italic>\u2009=\u200910; 47.6%). During a median follow-up of 29.6\u00a0months (IQR 10.9\u201344.0), severe VA occurred in 3 (14.3%) patients aged 15.6\u00a0(IQR\u00a014.7\u201316.1) a median of 12.3\u00a0months (IQR\u00a011.2\u201322.3) after PPVI. All events occurred in patients with TOF-like physiology following Melody valve implant. In conclusion, severe VA can occur long after PPVI in a pediatric population, particularly in those with TOF-like physiology. Further studies are required to elucidate underlying mechanisms and assess strategies to mitigate risks.<\/jats:p>","DOI":"10.1007\/s00246-022-02881-5","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T08:04:32Z","timestamp":1649405072000},"page":"1539-1547","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Ventricular Arrhythmias and Sudden Death Following Percutaneous Pulmonary Valve Implantation in Pediatric Patients"],"prefix":"10.1007","volume":"43","author":[{"given":"Pierre-Olivier","family":"Veillette","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaquim","family":"Miro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Khairy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia","family":"Abadir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8355-1179","authenticated-orcid":false,"given":"Mathieu","family":"Le Bloa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,8]]},"reference":[{"key":"2881_CR1","doi-asserted-by":"publisher","first-page":"593","DOI":"10.1056\/NEJM199308263290901","volume":"329","author":"JG Murphy","year":"1993","unstructured":"Murphy JG, Gersh BJ, Mair DD, Fuster V, McGoon MD, Ilstrup DM, McGoon DC, Kirklin JW, Danielson GK (1993) Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. 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