Tetralogy of fallot ACC/AHA guidelines for evaluation and follow up


 * Associate Editors-In-Chief: Priyamvada Singh, M.B.B.S. [mailto:psingh@perfuse.org], Keri Shafer, M.D. [mailto:kshafer@bidmc.harvard.edu]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [mailto:kfeeney@perfuse.org]

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 (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 (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