VT Prevention in Repaired Tetralogy of Fallot: Mapping SCAI and Minimizing ICDs | JACC Baran
JACC This Week20 Maj 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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Season 2 Wrap-Up: Thank You, Reflections, and What Comes Next | JACC This Week

Season 2 Wrap-Up: Thank You, Reflections, and What Comes Next | JACC This Week

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March 31, 2026: Global Cardiovascular Insights & Breakthroughs from China | JACC This Week

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17 Mars 17min

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March 3, 2026: Hypertrophic Cardiomyopathy  in Focus—MAPLE-HCM Trial, Myosin Inhibitors & What Improvement Really Means | JACC This Week

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In this episode of JACC This Week, Dr. Carolyn Lam and Dr. Harlan Krumholz spotlight a mini-focus issue on hypertrophic cardiomyopathy (HCM), a field undergoing rapid transformation. The discussion ce...

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February 24, 2026: ACHD Guideline in Focus—From Survival to Stewardship | JACC This Week

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JACC This Week Bonus Episode – Women's Cardiovascular Health: From Inclusion to Redesign

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