{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T01:09:11Z","timestamp":1781744951918,"version":"3.54.5"},"reference-count":34,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1998,7,8]]},"published-print":{"date-parts":[[1999,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>To examine autonomic function as assessed by heart rate variability in patients 10 or more years after repair of tetralogy of Fallot, and to relate this to cardiac structure, function, and electrocardiographic indices.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec sec-type=\"methods\">\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Heart rate variability was measured by standard time domain techniques on a 24 hour Holter ECG in 28 patients, aged 12 to 34 years (mean 19.5), who had undergone repair of tetralogy of Fallot at least 10 years previously. Echocardiography was performed to assess left ventricular size and function, right ventricular size and pressure, and any proximal pulmonary arterial stenosis. Right ventricular function was evaluated by radionuclide scan. QRS duration, QT interval, and QT dispersion were measured on a standard 12 lead ECG. Measurements of heart rate variability were compared with values from 28 age matched healthy controls (mean age 19.9 years). Interrelations between variables were assessed using Pearson correlation coefficients and stepwise regression analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Heart rate variability was reduced, compared with values for age matched normal controls, in 12 of the 28 patients. Reduced heart rate variability was associated with increased age, increased right ventricular size and pressure, and widening of the QRS complex.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Reduced heart rate variability is a feature following repair of tetralogy of Fallot. It is associated with increasing age, impaired right ventricular haemodynamics, and widening of the QRS complex. Under these circumstances, reduced heart rate variability may be a marker for deteriorating right ventricular function. Increased QRS duration has been identified as a risk factor for sudden death following repair of tetralogy of Fallot, and impaired cardiac autonomic control may be one of the mechanisms involved.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/hrt.81.6.656","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"656-660","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Reduced heart rate variability following repair of tetralogy of Fallot"],"prefix":"10.1136","volume":"81","author":[{"given":"K A","family":"McLeod","sequence":"first","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W S","family":"Hillis","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A B","family":"Houston","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N","family":"Wilson","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Trainer","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Neilson","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W B","family":"Doig","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, Royal Hospital for Sick Children, Glasgow  G3 8SJ, UK, \n\nbRobertson Centre for Biostatistics, Glasgow University, Glasgow, UK, \n\ncDepartment of Medical Physics, Royal Infirmary, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1999,6,1]]},"reference":[{"key":"2025092006444137000_81.6.656.1","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1161\/01.CIR.54.2.289","article-title":"Sudden death among post-operative patients with tetralogy of Fallot: a follow-up study of 243 patients for an average of twelve years.","volume":"54","author":"Quattlebaum","year":"1976","journal-title":"Circulation"},{"key":"2025092006444137000_81.6.656.2","unstructured":"Stevenson WG Klitzer T Perloff JK (1991) Electrophysiological abnormalities. in Congenital heart disease in adults. eds Perloff JK Child JS (WB Saunders, Philadelphia), pp 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