Predicting late sudden death from ventricular arrhythmia in adults following surgical repair of tetralogy of Fallot

Tetralogy of Fallot was the first complex congenital cardiac defect to undergo open repair. The life expectancy and quality of life of those surviving surgery is now good, although late survival is compromised by the occurrence of sudden death. The emergence of successful methods for both the prevention of arrhythmias (including valve replacements and electrophysiological ablation) and the treatment of arrhythmias when they occur (including implantable defibrillators), has meant the identification of those at risk is of even greater importance. This paper reviews the predictive methods currently available to the practising physician caring for these increasingly common patients.