Arrhythmias in tetralogy of Fallot (ToF) and transposition of the great arteries (TGA) could be
the consequence of reduced baroreflex-sensitivity (BRS). Hypoxia until the first surgical
correction in these patients may impair BRS. We aimed to compare the BRS of ToF, TGA and
control subjects and test the effect of the timing of operation on BRS.
19 patients with ToF, 22 patients with TGA and 19 healthy controls were enrolled. Carotid pulse
pressure (PPc) was similar in ToF and TGA patients but lower in controls. BRS was lower in the
ToF group compared to the control or to the TGA groups. The first operation was performed
later in patients with ToF than in patients with TGA. Adjustment for PPc attenuated the
difference in BRS between ToF and control subjects. Adjustment for age at corrective surgery
abolished the difference in BRS between the ToF and the TGA groups.
In ToF patients, reduced BRS could be explained by the stiffening of central arteries and the
later corrective surgery. Earlier surgical correction may prevent irreversible deterioration of
baroreflex-function and arrhythmia development in ToF patients
