Ventricular Tachycardia in Repaired Tetralogy of Fallot

Ventricular tachycardia in repaired Tetralogy of Fallot is associated with significant morbidity and mortality. The dominant substrate of ventricular tachycardia in repaired Tetralogy of Fallot are slow conducting anatomical isthmuses in the right ventricular outflow tract. The anatomical isthmuses in repaired Tetralogy of Fallot are the result of the malformation itself or the result of the correction. In this thesis is demonstrated that radiofrequency catheter ablation of anatomical isthmus related ventricular tachycardia can be considered curative and prevent ICD implantation in patients with a preserved cardiac function. Risk stratification for ventricular tachycardia in patients with repaired Tetralogy of Fallot has been difficult. In this thesis is demonstrated that electroanatomical mapping in patients with repaired Tetralogy of Fallot can be used to assess the presence and properties of the anatomical isthmuses in order to perform individualized risk stratification. Further, in this thesis, patients with repaired Tetralogy of Fallot and a right bundle branch block with a QRS duration of ≥150 milliseconds have a blocked or slow conducting anatomical isthmus and should undergo invasive electroanatomical mapping to differentiate between a slow conducting or blocked anatomical isthmus. Dutch Heart Foundation, Abbott Medical Nederland B.V., BIOTRONIK Nederland B.V., Canon Medical Systems Nederland, ChipSoft, Pfizer B.V. and Servier Nederland Farma B.V.LUMC / Geneeskunde Repositoriu

Early career perspectives of young Dutch cardiologists

Background There are nationwide concerns about the unemployment rate among young Dutch cardiologists and the increase in temporary positions. Therefore, the aim of this study was to investigate the unemployment rate in this subgroup as well as the length of time between the end of their training and the acquisition of a permanent position. Methods All cardiologists who completed their training between January 2015 and December 2018 were invited to fill in an online questionnaire about their demographic characteristics, professional profile and employment status. The unemployment rate was calculated and Kaplan-Meier curves were used to determine the time between the end of training and the first permanent contract. Results In total, 174 participants were included (mean age 35 +/- 3 years, 64% male, median follow-up 2.3 years (interquartile range 1.4-3.2 years)). The unemployment rate was 0.6% (n = 1). Only 12 participants (7%) started their career with a permanent position. The percentage of cardiologists with a temporary position was 82%, 61% and 33% at 1, 2 and 3 years, respectively. The percentage of cardiologists with a temporary position did not differ with regard to age, gender, holding a PhD degree or type of teaching institution attended (academic vs non-academic). Forty-four per cent of participants perceived the current job market to be problematic. Conclusions The unemployment rate among young cardiologists in the Netherlands was low between 2015 and 2018. The vast majority of cardiologists start their career on a temporary contract. Three years later, 33% still hold temporary positions. Due to the resultant job insecurity, many young cardiologists describe the job market as problematic.Cardiolog

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