Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

Francis Bessière; Kévin Gardey; Abdeslam Bouzeman; Guillaume Duthoit; Linda Koutbi; Fabien Labombarda; Christelle Marquié; Jean Baptiste Gourraud; Pierre Mondoly; Jean Marc Sellal; Pierre Bordachar; Alexis Hermida; Frédéric Anselme; Anouk Asselin; Caroline Audinet; Yvette Bernard; Serge Boveda; Philippe Chevalier; Gael Clerici; Antoine da Costa; Maxime de Guillebon; Pascal Defaye; Romain Eschalier; Rodrigue Garcia; Charles Guenancia; Benoit Guy-Moyat; Roland Henaine; Didier Irles; Laurence Iserin; François Jourda; Magalie Ladouceur; Philippe Lagrange; Mikael Laredo; Jacques Mansourati; Grégoire Massoulié; Amel Mathiron; Philippe Maury; Cédric Nguyen; Sandro Ninni; Marie-Cécile Perier; Bertrand Pierre; Frédéric Sacher; Camille Walton; Pierre Winum; Raphaël Martins; Jean Luc Pasquié; Jean Benoit Thambo; Xavier Jouven; Nicolas Combes; Sylvie Di Filippo; Eloi Marijon; Victor Waldmann

doi:10.1016/j.jacep.2021.02.022

Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

Francis Bessière, Kévin Gardey, Abdeslam Bouzeman, Guillaume Duthoit, Linda Koutbi, Fabien Labombarda, Christelle Marquié, Jean Baptiste Gourraud, Pierre Mondoly, Jean Marc Sellal, Pierre Bordachar, Alexis Hermida, Frédéric Anselme, Anouk Asselin, Caroline Audinet, Yvette Bernard, Serge Boveda, Philippe Chevalier, Gael Clerici, Antoine da CostaMaxime de Guillebon, Pascal Defaye, Romain Eschalier, Rodrigue Garcia, Charles Guenancia, Benoit Guy-Moyat, Roland Henaine, Didier Irles, Laurence Iserin, François Jourda, Magalie Ladouceur, Philippe Lagrange, Mikael Laredo, Jacques Mansourati, Grégoire Massoulié, Amel Mathiron, Philippe Maury, Cédric Nguyen, Sandro Ninni, Marie-Cécile Perier, Bertrand Pierre, Frédéric Sacher, Camille Walton, Pierre Winum, Raphaël Martins, Jean Luc Pasquié, Jean Benoit Thambo, Xavier Jouven, Nicolas Combes, Sylvie Di Filippo, Eloi Marijon, Victor Waldmann

Clinical sciences

Research output: Contribution to journal › Article › peer-review

27 Citations (Scopus)

Abstract

OBJECTIVES: This study aimed to assess the impact of pulmonary valve replacement (PVR) on ventricular arrhythmias burden in a population of tetralogy of Fallot (TOF) patients with continuous cardiac monitoring by implantable cardioverter-defibrillators (ICDs).

BACKGROUND: Sudden cardiac death is a major cause of death in TOF, and right ventricular overload is commonly considered to be a potential trigger for ventricular arrhythmias.

METHODS: Data were analyzed from a nationwide French ongoing study (DAI-T4F) including all TOF patients with an ICD since 2000. Survival data with recurrent events were used to compare the burden of appropriate ICD therapies before and after PVR in patients who underwent PVR over the study period.

RESULTS: A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% male) were included from 40 centers. Over a median follow-up period of 6.8 (interquartile range: 2.5 to 11.4) years, 26 patients (15.8%) underwent PVR. Among those patients, 18 (69.2%) experienced at least 1 appropriate ICD therapy. When considering all ICD therapies delivered before (n = 62) and after (n = 16) PVR, the burden of appropriate ICD therapies was significantly lower after PVR (HR: 0.21; 95% confidence interval [CI]: 0.08 to 0.56; p = 0.002). Respective appropriate ICD therapies rates per 100 person-years were 44.0 (95% CI: 35.7 to 52.5) before and 13.2 (95% CI: 7.7 to 20.5) after PVR (p < 0.001). In the overall cohort, PVR before ICD implantation was also independently associated with a lower risk of appropriate ICD therapy in primary prevention patients (HR: 0.29 [95% CI: 0.10 to 0.89]; p = 0.031).

CONCLUSIONS: In this cohort of high-risk TOF patients implanted with an ICD, the burden of appropriate ICD therapies was significantly reduced after PVR. While optimal indications and timing for PVR are debated, these findings suggest the importance of considering ventricular arrhythmias in the overall decision-making process. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574).

Original language	English
Pages (from-to)	1285-1293
Number of pages	9
Journal	JACC. Clinical electrophysiology
Volume	7
Issue number	10
DOIs	https://doi.org/10.1016/j.jacep.2021.02.022
Publication status	Published - Oct 2021

Bibliographical note

Keywords

Adult
Arrhythmias, Cardiac/therapy
Cardiac Surgical Procedures
Defibrillators, Implantable
Female
Humans
Male
Middle Aged
Pulmonary Valve/surgery
Tetralogy of Fallot/surgery

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Bessière, F., Gardey, K., Bouzeman, A., Duthoit, G., Koutbi, L., Labombarda, F., Marquié, C., Gourraud, J. B., Mondoly, P., Sellal, J. M., Bordachar, P., Hermida, A., Anselme, F., Asselin, A., Audinet, C., Bernard, Y., Boveda, S., Chevalier, P., Clerici, G., ... Waldmann, V. (2021). Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator. JACC. Clinical electrophysiology, 7(10), 1285-1293. https://doi.org/10.1016/j.jacep.2021.02.022

@article{1462680249ac4cfd9aa447dbe12913e3,

title = "Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator",

abstract = "OBJECTIVES: This study aimed to assess the impact of pulmonary valve replacement (PVR) on ventricular arrhythmias burden in a population of tetralogy of Fallot (TOF) patients with continuous cardiac monitoring by implantable cardioverter-defibrillators (ICDs).BACKGROUND: Sudden cardiac death is a major cause of death in TOF, and right ventricular overload is commonly considered to be a potential trigger for ventricular arrhythmias.METHODS: Data were analyzed from a nationwide French ongoing study (DAI-T4F) including all TOF patients with an ICD since 2000. Survival data with recurrent events were used to compare the burden of appropriate ICD therapies before and after PVR in patients who underwent PVR over the study period.RESULTS: A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% male) were included from 40 centers. Over a median follow-up period of 6.8 (interquartile range: 2.5 to 11.4) years, 26 patients (15.8%) underwent PVR. Among those patients, 18 (69.2%) experienced at least 1 appropriate ICD therapy. When considering all ICD therapies delivered before (n = 62) and after (n = 16) PVR, the burden of appropriate ICD therapies was significantly lower after PVR (HR: 0.21; 95% confidence interval [CI]: 0.08 to 0.56; p = 0.002). Respective appropriate ICD therapies rates per 100 person-years were 44.0 (95% CI: 35.7 to 52.5) before and 13.2 (95% CI: 7.7 to 20.5) after PVR (p < 0.001). In the overall cohort, PVR before ICD implantation was also independently associated with a lower risk of appropriate ICD therapy in primary prevention patients (HR: 0.29 [95% CI: 0.10 to 0.89]; p = 0.031).CONCLUSIONS: In this cohort of high-risk TOF patients implanted with an ICD, the burden of appropriate ICD therapies was significantly reduced after PVR. While optimal indications and timing for PVR are debated, these findings suggest the importance of considering ventricular arrhythmias in the overall decision-making process. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574).",

keywords = "Adult, Arrhythmias, Cardiac/therapy, Cardiac Surgical Procedures, Defibrillators, Implantable, Female, Humans, Male, Middle Aged, Pulmonary Valve/surgery, Tetralogy of Fallot/surgery",

author = "Francis Bessi{\`e}re and K{\'e}vin Gardey and Abdeslam Bouzeman and Guillaume Duthoit and Linda Koutbi and Fabien Labombarda and Christelle Marqui{\'e} and Gourraud, {Jean Baptiste} and Pierre Mondoly and Sellal, {Jean Marc} and Pierre Bordachar and Alexis Hermida and Fr{\'e}d{\'e}ric Anselme and Anouk Asselin and Caroline Audinet and Yvette Bernard and Serge Boveda and Philippe Chevalier and Gael Clerici and {da Costa}, Antoine and {de Guillebon}, Maxime and Pascal Defaye and Romain Eschalier and Rodrigue Garcia and Charles Guenancia and Benoit Guy-Moyat and Roland Henaine and Didier Irles and Laurence Iserin and Fran{\c c}ois Jourda and Magalie Ladouceur and Philippe Lagrange and Mikael Laredo and Jacques Mansourati and Gr{\'e}goire Massouli{\'e} and Amel Mathiron and Philippe Maury and C{\'e}dric Nguyen and Sandro Ninni and Marie-C{\'e}cile Perier and Bertrand Pierre and Fr{\'e}d{\'e}ric Sacher and Camille Walton and Pierre Winum and Rapha{\"e}l Martins and Pasqui{\'e}, {Jean Luc} and Thambo, {Jean Benoit} and Xavier Jouven and Nicolas Combes and {Di Filippo}, Sylvie and Eloi Marijon and Victor Waldmann",

year = "2021",

month = oct,

doi = "10.1016/j.jacep.2021.02.022",

language = "English",

volume = "7",

pages = "1285--1293",

journal = "JACC. Clinical electrophysiology",

issn = "2405-500X",

publisher = "Elsevier",

number = "10",

}

Bessière, F, Gardey, K, Bouzeman, A, Duthoit, G, Koutbi, L, Labombarda, F, Marquié, C, Gourraud, JB, Mondoly, P, Sellal, JM, Bordachar, P, Hermida, A, Anselme, F, Asselin, A, Audinet, C, Bernard, Y, Boveda, S, Chevalier, P, Clerici, G, da Costa, A, de Guillebon, M, Defaye, P, Eschalier, R, Garcia, R, Guenancia, C, Guy-Moyat, B, Henaine, R, Irles, D, Iserin, L, Jourda, F, Ladouceur, M, Lagrange, P, Laredo, M, Mansourati, J, Massoulié, G, Mathiron, A, Maury, P, Nguyen, C, Ninni, S, Perier, M-C, Pierre, B, Sacher, F, Walton, C, Winum, P, Martins, R, Pasquié, JL, Thambo, JB, Jouven, X, Combes, N, Di Filippo, S, Marijon, E & Waldmann, V 2021, 'Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator', JACC. Clinical electrophysiology, vol. 7, no. 10, pp. 1285-1293. https://doi.org/10.1016/j.jacep.2021.02.022

TY - JOUR

T1 - Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

AU - Bessière, Francis

AU - Gardey, Kévin

AU - Bouzeman, Abdeslam

AU - Duthoit, Guillaume

AU - Koutbi, Linda

AU - Labombarda, Fabien

AU - Marquié, Christelle

AU - Gourraud, Jean Baptiste

AU - Mondoly, Pierre

AU - Sellal, Jean Marc

AU - Bordachar, Pierre

AU - Hermida, Alexis

AU - Anselme, Frédéric

AU - Asselin, Anouk

AU - Audinet, Caroline

AU - Bernard, Yvette

AU - Boveda, Serge

AU - Chevalier, Philippe

AU - Clerici, Gael

AU - da Costa, Antoine

AU - de Guillebon, Maxime

AU - Defaye, Pascal

AU - Eschalier, Romain

AU - Garcia, Rodrigue

AU - Guenancia, Charles

AU - Guy-Moyat, Benoit

AU - Henaine, Roland

AU - Irles, Didier

AU - Iserin, Laurence

AU - Jourda, François

AU - Ladouceur, Magalie

AU - Lagrange, Philippe

AU - Laredo, Mikael

AU - Mansourati, Jacques

AU - Massoulié, Grégoire

AU - Mathiron, Amel

AU - Maury, Philippe

AU - Nguyen, Cédric

AU - Ninni, Sandro

AU - Perier, Marie-Cécile

AU - Pierre, Bertrand

AU - Sacher, Frédéric

AU - Walton, Camille

AU - Winum, Pierre

AU - Martins, Raphaël

AU - Pasquié, Jean Luc

AU - Thambo, Jean Benoit

AU - Jouven, Xavier

AU - Combes, Nicolas

AU - Di Filippo, Sylvie

AU - Marijon, Eloi

AU - Waldmann, Victor

PY - 2021/10

Y1 - 2021/10

N2 - OBJECTIVES: This study aimed to assess the impact of pulmonary valve replacement (PVR) on ventricular arrhythmias burden in a population of tetralogy of Fallot (TOF) patients with continuous cardiac monitoring by implantable cardioverter-defibrillators (ICDs).BACKGROUND: Sudden cardiac death is a major cause of death in TOF, and right ventricular overload is commonly considered to be a potential trigger for ventricular arrhythmias.METHODS: Data were analyzed from a nationwide French ongoing study (DAI-T4F) including all TOF patients with an ICD since 2000. Survival data with recurrent events were used to compare the burden of appropriate ICD therapies before and after PVR in patients who underwent PVR over the study period.RESULTS: A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% male) were included from 40 centers. Over a median follow-up period of 6.8 (interquartile range: 2.5 to 11.4) years, 26 patients (15.8%) underwent PVR. Among those patients, 18 (69.2%) experienced at least 1 appropriate ICD therapy. When considering all ICD therapies delivered before (n = 62) and after (n = 16) PVR, the burden of appropriate ICD therapies was significantly lower after PVR (HR: 0.21; 95% confidence interval [CI]: 0.08 to 0.56; p = 0.002). Respective appropriate ICD therapies rates per 100 person-years were 44.0 (95% CI: 35.7 to 52.5) before and 13.2 (95% CI: 7.7 to 20.5) after PVR (p < 0.001). In the overall cohort, PVR before ICD implantation was also independently associated with a lower risk of appropriate ICD therapy in primary prevention patients (HR: 0.29 [95% CI: 0.10 to 0.89]; p = 0.031).CONCLUSIONS: In this cohort of high-risk TOF patients implanted with an ICD, the burden of appropriate ICD therapies was significantly reduced after PVR. While optimal indications and timing for PVR are debated, these findings suggest the importance of considering ventricular arrhythmias in the overall decision-making process. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574).

AB - OBJECTIVES: This study aimed to assess the impact of pulmonary valve replacement (PVR) on ventricular arrhythmias burden in a population of tetralogy of Fallot (TOF) patients with continuous cardiac monitoring by implantable cardioverter-defibrillators (ICDs).BACKGROUND: Sudden cardiac death is a major cause of death in TOF, and right ventricular overload is commonly considered to be a potential trigger for ventricular arrhythmias.METHODS: Data were analyzed from a nationwide French ongoing study (DAI-T4F) including all TOF patients with an ICD since 2000. Survival data with recurrent events were used to compare the burden of appropriate ICD therapies before and after PVR in patients who underwent PVR over the study period.RESULTS: A total of 165 patients (mean age 42.2 ± 13.3 years, 70.1% male) were included from 40 centers. Over a median follow-up period of 6.8 (interquartile range: 2.5 to 11.4) years, 26 patients (15.8%) underwent PVR. Among those patients, 18 (69.2%) experienced at least 1 appropriate ICD therapy. When considering all ICD therapies delivered before (n = 62) and after (n = 16) PVR, the burden of appropriate ICD therapies was significantly lower after PVR (HR: 0.21; 95% confidence interval [CI]: 0.08 to 0.56; p = 0.002). Respective appropriate ICD therapies rates per 100 person-years were 44.0 (95% CI: 35.7 to 52.5) before and 13.2 (95% CI: 7.7 to 20.5) after PVR (p < 0.001). In the overall cohort, PVR before ICD implantation was also independently associated with a lower risk of appropriate ICD therapy in primary prevention patients (HR: 0.29 [95% CI: 0.10 to 0.89]; p = 0.031).CONCLUSIONS: In this cohort of high-risk TOF patients implanted with an ICD, the burden of appropriate ICD therapies was significantly reduced after PVR. While optimal indications and timing for PVR are debated, these findings suggest the importance of considering ventricular arrhythmias in the overall decision-making process. (French National Registry of Patients With Tetralogy of Fallot and Implantable Cardioverter Defibrillator [DAI-T4F]; NCT03837574).

KW - Adult

KW - Arrhythmias, Cardiac/therapy

KW - Cardiac Surgical Procedures

KW - Defibrillators, Implantable

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Pulmonary Valve/surgery

KW - Tetralogy of Fallot/surgery

UR - http://www.scopus.com/inward/record.url?scp=85119190438&partnerID=8YFLogxK

U2 - 10.1016/j.jacep.2021.02.022

DO - 10.1016/j.jacep.2021.02.022

M3 - Article

C2 - 33933408

SN - 2405-500X

VL - 7

SP - 1285

EP - 1293

JO - JACC. Clinical electrophysiology

JF - JACC. Clinical electrophysiology

IS - 10

ER -

Impact of Pulmonary Valve Replacement on Ventricular Arrhythmias in Patients With Tetralogy of Fallot and Implantable Cardioverter-Defibrillator

Abstract

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