VT Prevention in Repaired Tetralogy of Fallot: Mapping SCAI and Minimizing ICDs | JACC Baran
JACC Global29 Jul 2025

VT Prevention in Repaired Tetralogy of Fallot: Mapping SCAI and Minimizing ICDs | JACC Baran

Hosts Mitsuaki Sawano, MD, and Nobuhiro Ikemura, MD, welcome Yoshitaka Kimura, MD, PhD, of Leiden University Medical Center, to discuss proactive ablation strategies in patients with repaired Tetralogy of Fallot (rTOF). Dr. Kimura presents data from a long-term, single-center study evaluating electroanatomical mapping and preventive ablation of slow-conducting anatomical isthmuses (SCAI) in rTOF patients without prior ventricular tachycardia (VT). The findings show that identifying and successfully ablating SCAI significantly reduced VT incidence, with all VT events occurring in patients where ablation failed. Moreover, this approach reduced the proportion of patients qualifying for ICD implantation from 25–51% under current guidelines to just 11%. Dr. Kimura underscores a paradigm shift in congenital heart disease management—from treating VT reactively to preventing it proactively—highlighting the value of data-driven, tailored care strategies that avoid unnecessary device implantation and better target high-risk individuals.

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Episoder(93)

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

Is immune checkpoint inhibitor (ICI)-associated myocarditis the same disease when it occurs early versus months after starting cancer therapy? Host Mitsuaki Sawano, MD, and co-host Shun Kohsaka, MD, w...

3 Nov 34min

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

ICI Myocarditis: Does Timing Define the Disease? | JACC Baran

Is immune checkpoint inhibitor (ICI)-associated myocarditis the same disease when it occurs early versus months after starting cancer therapy? Host Mitsuaki Sawano, MD, and co-host Shun Kohsaka, MD, w...

3 Nov 34min

Does PFA Reach the Vein of Marshall? | JACC Baran

Does PFA Reach the Vein of Marshall? | JACC Baran

Does pulsed field ablation (PFA) for pulmonary vein isolation affect structures beyond the pulmonary veins? Host Mitsuaki Sawano, MD, welcomes Yosuke Nakatani, MD (Gunma University) to discuss his rec...

27 Okt 36min

A SELUTION to Paclitaxel DCB Complications in PAD? | JACC Baran

A SELUTION to Paclitaxel DCB Complications in PAD? | JACC Baran

Could sirolimus-coated balloons change how we treat femoropopliteal peripheral artery disease? Host Mitsuaki Sawano, MD, welcomes Yoshimitsu Soga, MD, PhD (Kokura Memorial Hospital) to discuss the 3-y...

20 Okt 28min

Proteomics in Action: Finding the Right Drug Targets for Ischemic Heart Disease | JACC Baran

Proteomics in Action: Finding the Right Drug Targets for Ischemic Heart Disease | JACC Baran

Which of the thousands of biomarkers associated with cardiovascular disease could actually become a useful drug target? Host Mitsuaki Sawano, MD, and co-host Nobuhiro Ikemura, MD, welcome Satoshi Yosh...

13 Okt 35min

PET Unmasks CMD: The Hidden Risk Behind Normal Perfusion | JACC Baran

PET Unmasks CMD: The Hidden Risk Behind Normal Perfusion | JACC Baran

Hosts Mitsuaki Sawano, MD, Satoshi Shoji, MD, and Kentaro Ejiri, MD, welcome Yoshito Kadoya, MD, PhD (University of British Columbia / St. Paul’s Hospital) to discuss his JACC: Cardiovascular Imaging ...

6 Okt 36min

Rethinking Health Care at Home and Abroad: Lancet RH Western Pacific Special | JACC Baran

Rethinking Health Care at Home and Abroad: Lancet RH Western Pacific Special | JACC Baran

Host Mitsuaki Sawano, MD, welcomes Shuhei Nomura, PhD (Tohoku University), Lisa Yamasaki, MD (Harvard T.H. Chan School of Public Health), and Haruka Sakamoto, MD, PhD (St. Luke’s International Hospita...

29 Sep 39min

PFA Changes the Game and the AT Circuit | JACC Baran

PFA Changes the Game and the AT Circuit | JACC Baran

Hosts Mitsuaki Sawano, MD, and Hiroyuki Sato, MD, welcome Kazutaka Nakasone, MD (Kobe University) to discuss his JACC: Clinical Electrophysiology study on atrial tachycardia (AT) after pulsed field ab...

22 Sep 36min

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