Electrophysiology testing before transcatheter pulmonary valve replacement in patients with repaired tetralogy of Fallot

Graphical Abstract Graphical abstract Pathophysiology of ventricular arrhythmia for repaired tetralogy of Fallot in relation to native right ventricular outflow tract transcatheter pulmonary valve replacement. Following repair, progressive degenerative remodelling incurs a risk for sustained monomorphic ventricular tachycardia. With transcatheter pulmonary valve replacement, ventricular tachycardia can become inaccessible to catheter ablation. A and B, trichrome stain demonstrating interstitial and replacement fibrosis in regions between the pulmonary annulus and ventriculotomy incision or ventricular septal defect patch, respectively (courtesy of UCLA pathology archives).