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This editorial refers to ‘Reduction of QRS duration after pulmonary valve replacement in adult Fallot patients is related to reduction of right ventricular volume’† by B. Hooft van Huysduynen et al. , on page 928 Tetralogy of Fallot is the commonest form of cyanotic congenital heart disease, and early outcomes following surgical repair are steadily improving. Nonetheless, these patients remain at risk for late-onset arrhythmias as well as sudden death.1,2 Increased QRS duration and right ventricular (RV) dilation secondary to pulmonary regurgitation have both been described as markers for increased risk of ventricular arrhythmias and sudden death.3–5 Pulmonary valve replacement (PVR) in these patients has been shown to stabilize the QRS duration and, when combined with cryoablation, to decrease the incidence of ventricular arrhythmias.6Hooft van Huysduyen et al. 7 present a retrospective series of adult patients with tetralogy of Fallot, who were assessed before and … *Corresponding author. E-mail address: andrew.redington{at}sickkids.ca

Reduction of QRS duration following pulmonary valve replacement in tetralogy of Fallot: implications for arrhythmia reduction?