Arrhythmias in Congenital Heart Disease: Tetralogy of Fallot.

Tetralogy of Fallot is the most common cyanotic congenital heart disease, characterized by 4 defects: pulmonary outflow obstruction, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Advances in surgical repair have significantly improved survival, but patients remain at risk for long-term complications, especially arrhythmias. Immediate postoperative arrhythmias include junctional ectopic tachycardia, complete heart block, while long-term atrial tachycardias, and life-threatening ventricular tachycardias occur linked to scar-related reentry circuits. Modern management includes antiarrhythmic medications, catheter ablation, and implantable cardioverted defibrillators, with newer strategies focusing on identifying and ablating slow-conducting anatomical isthmuses for ventricular tachycardia.