Objectives:
This study aims to define prevalence of ventricular tachycardia and review indications for intraoperative RVOT cryoablation and postoperative ICD implantation in patients indicated for PVR following TOF repair in our unit.

Methods:
Retrospective data were collected from clinical notes of 34 survivors of PVR following TOF repair between January 2003 and November 2008, one died patient was excluded.

Results:
PVR was performed at median age of 24.4 years (range 15.7-50.1) and 21.0 years (10.8-44.3) after TOF repair.
Preoperatively, 22 (64.7%) patients reported palpitations, including 12 (35.3%) with preoperative VT (nine had history of documented VT on ECG, one newly recorded nonsustained VT on 24 hours’ tape and two newly inducible VT on EPS).
Three (8.8%) patients underwent intraoperative RVOT cryoablation (due to VT on preoperative EPS in two, recurrent VF during resternotomy and preoperative QRS>180 ms in one).
Ten (29.4%) patients received ICD at median of 0.4 years (0.1-4.2) postoperatively. All RVOT cryoablated patients were palpitations free, one had negative and one is awaiting EPS.

Conclusion:
This study shows that prevalence of VT among patients after TOF repair indicated for PVR is as high as 35.3%. These patients were primarily indicated for postoperative ICD implantation. Recently, we decided to indicate all patients with VT prior to PVR for intraoperative RVOT cryoablation followed by postoperative EPS. Only patients with positive postoperative EPS will be referred for ICD. This can decrease patients’ morbidity and spare financial resources. Our initial limited results are promising and are part of current prospective study.