Components of Tetralogy of Fallot (ToF)

  Ventricular septal defect (VSD).

  Obstruction to right ventricular outflow.

  Dextroposition (overriding) of the aorta

  Right ventricular hypertrophy.

ECG abnormalities that are frequently observed in patients with ToF

  Right atrial abnormality ( RAA ).

  Right ventricular hypertrophy (
RVH ).

  Right axis deviation .

  Right bundle branch block (
RBBB ) is frequently observed after corrective surgery.

      Left anterior fascicular block may accompany.

  Atrial arrhythmias are frequently observed after corrective surgery.

  Ventricular arrhythmias may be observed after corrective surgery.

  If QRS width is
> 180 msec, this suggests an increased risk for development of ventricular arryhthmias

      and sudden cardiac death.


  Chou's Electrocardiography in Clinical Practice. Adult and Pediatric.

      5th ed. Philadelphia. WB Saunders. 2001.

  Am J Cardiol 1997;80:160.

  Circulation 1995;92:231.

  Circulation 1975;52:691.

ECG 1. The ECG of a 7 years old boy who was operated for ToF one year ago. He is under congestive heart failure therapy.

Pediatric cardiologist Dr. Mahmut Gokdemir has donated the above ECG to our website.

Click here for a more detailed ECG