Tetralogy of fallot electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Fahimeh Shojaei, M.D., Priyamvada Singh, M.B.B.S. [2], Keri Shafer, M.D. [3];Kristin Feeney, B.S. [4]

Overview

An ECG may be helpful in the diagnosis of tetralogy of Fallot. Findings on an ECG suggestive of tetralogy of Fallot include right axis deviation, right ventricular hypertrophy, wide QRS, and right bundle branch block.

Electrocardiogram

An ECG may be helpful in the diagnosis of tetralogy of Fallot. Findings on an ECG suggestive of tetralogy of Fallot include:

The EKG often shows right axis deviation and right ventricular hypertrophy in tetralogy of Fallot.
Wider QRS correlates with worse right ventricle dysfunction.
Right atrial enlargement may be present.
Right bundle branch block is present in 95% of patients with tetrology of fellot, particularly following surgical repair.

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1]

2008 ACC/AHA Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)^[1]

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) ”

References