Tetralogy of fallot ACC/AHA guidelines for evaluation and follow up
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [2], Keri Shafer, M.D. [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]
Overview
Annual follow-up is recommended in patients with repaired Tetralogy of Fallot. Echocardiographic follow-up should be performed at qualified centers to evaluate for residual defects.
The(ACC/AHA) recommendations for evaluation and follow-up in the repaired patients of Tetralogy of Fallot [1](DONOT EDIT)
| Class I |
| "1. Patients with repaired tetralogy of Fallot should have at least annual follow-up with a cardiologist who has expertise in adult congenital heart disease (ACHD). (Level of Evidence: C)" |
| "2. Patients with tetralogy of Fallot should have echocardiographic examinations and/or magnetic resonance imagings (MRIs) performed by staff with expertise in ACHD. (Level of Evidence: C)" |
| "3. Screening for heritable causes of their condition (e.g., 22q11 deletion) should be offered to all patients with tetralogy of Fallot. (Level of Evidence: C)" |
| "4. Before pregnancy or if a genetic syndrome is identified, consultation with a geneticist should be arranged for patients with tetralogy of Fallot. (Level of Evidence: B)" |
| "5. Patients with unrepaired or palliated forms of tetralogy should have a formal evaluation at an ACHD center regarding suitability for repair. (Level of Evidence: B)" |
| Recommendations for Imaging:Class 1 |
| "1. Comprehensive echocardiographic imaging should be performed in a regional ACHD center to evaluate the anatomy and hemodynamics in patients with repaired tetralogy of Fallot. (Level of Evidence: B)" |
The(ACC/AHA) recommendations for evaluation and follow-up in patients of Tetralogy of Fallot [1](DONOT EDIT)
Recommendations for Arrhythmias: Pacemaker/Electrophysiology Testing
| Class I |
| "1. Annual surveillance with history, electrocardiogram (ECG), assessment of RV function, and periodic exercise testing is recommended for patients with pacemakers/automatic implantable cardioverter defibrillators. (Level of Evidence: C)" |
| Class IIa |
| 1. Periodic Holter monitoring can be beneficial as part of routine follow-up. The frequency should be individualized depending on the hemodynamics and clinical suspicion of arrhythmia. (Level of Evidence: C) |
| Class IIb |
| 1. Electrophysiology testing in an ACHD center may be reasonable to define suspected arrhythmias in adults with tetralogy of Fallot. (Level of Evidence: C) |
For ACC/AHA Level of evidence and classes click:ACC AHA Guidelines Classification Scheme
References
- ↑ 1.0 1.1 Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.
See also
External links
- Information by University of Michigan Health System
- Diagram of the condition
- Information for adults with ToF from the Adult Congenital Heart Association
de:Fallot-Tetralogie it:Tetralogia di Fallot nl:Tetralogie van Fallot nn:Fallots tetrade uk:Тетрада Фалло