{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:00:26Z","timestamp":1793347226487,"version":"4.5.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ventricular arrhythmias and sudden death are recognized complications in tetralogy of Fallot. Electrophysiological studies (EPS) before pulmonary valve replacement (PVR), the most common reintervention in tetralogy of Fallot, could potentially inform therapy to improve arrhythmic outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective multicenter study was conducted to systematically assess EPS with programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR from January 2020 to December 2021. A standardized stimulation protocol was used across all centers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 120 patients were enrolled, mean age 39.2\u00b114.5 years, 53.3% males. Sustained ventricular tachycardia was induced in 27 (22.5%) patients. When identifiable, the critical isthmus most commonly implicated (ie, in 90.0%) was between the ventricular septal defect patch and pulmonary annulus. Factors independently associated with inducible ventricular tachycardia were history of atrial arrhythmia (odds ratio, 8.56 [95% CI, 2.43\u201334.73]) and pulmonary annulus diameter &gt;26 mm (odds ratio, 5.05 [95% CI, 1.47\u201321.69]). The EPS led to a substantial change in management in 23 (19.2%) cases: 18 (15.0%) had catheter ablation, 3 (2.5%) surgical cryoablation during PVR, and 9 (7.5%) defibrillator implantation. Repeat EPS 5.1 (4.8\u20136.2) months after PVR was negative in 8 of 9 (88.9%) patients. No patient experienced a sustained ventricular arrhythmia during 13 (6.1\u201320.1) months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Systematically performing programmed ventricular stimulation in patients with tetralogy of Fallot referred for PVR yields a high rate of inducible ventricular tachycardia and carries the potential to alter management. It remains to be determined whether a standardized treatment approach based on the results of EPS will translate into improved outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04205461\">https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04205461<\/jats:ext-link>\n                      ; Unique identifier: NCT04205461\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circep.122.011745","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T05:00:39Z","timestamp":1683867639000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Systematic Electrophysiological Study Prior to Pulmonary Valve Replacement in Tetralogy of Fallot: A Prospective Multicenter Study"],"prefix":"10.1161","volume":"16","clinical-trial-number":[{"clinical-trial-number":"nct04205461","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8057-1900","authenticated-orcid":true,"given":"Victor","family":"Waldmann","sequence":"first","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)."},{"name":"Adult Congenital Heart Disease Medico-Surgical Unit, European Georges Pompidou Hospital, France (V.M., A.-S.C., L.I., M.L., A.L., M.M.K.)."},{"name":"M3C-Necker, H\u00f4pital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., S.M.-M.)."},{"name":"Cardiac Electrophysiology Unit, European Georges Pompidou Hospital, Paris, France (V.W., E.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3642-9795","authenticated-orcid":true,"given":"Francis","family":"Bessi\u00e8re","sequence":"additional","affiliation":[{"name":"Louis Pradel Hospital, Hospices Civils de Lyon, Universit\u00e9 Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Gardey","sequence":"additional","affiliation":[{"name":"Louis Pradel Hospital, Hospices Civils de Lyon, Universit\u00e9 Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Bakloul","sequence":"additional","affiliation":[{"name":"Louis Pradel Hospital, Hospices Civils de Lyon, Universit\u00e9 Lyon 1 Claude Bernard, France (F.B., K.G., M.B., S.D.F., A.D., R.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8326-6610","authenticated-orcid":true,"given":"Emre","family":"Belli","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Diseases, Centre de R\u00e9f\u00e9rence Malformations Cardiaques Cong\u00e9nitales Complexes M3C, H\u00f4pital Marie Lannelongue, Groupe Hospitalier Paris-Saint Joseph, Plessis-Robinson, Paris, France (E.B., S.C., S.H., J.R., A.M., N.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8722-5805","authenticated-orcid":true,"given":"Damien","family":"Bonnet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Cit\u00e9, Inserm, PARCC, France (V.W., D.B., M.L., E.M.)."},{"name":"M3C-Necker, H\u00f4pital Universitaire Necker-Enfants malades, APHP, France (V.W., D.B., A.L., 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