Clinical Characteristics of Patients with Tetralogy of Fallot who Underwent an Invasive Procedure for Arrhythmias

Introduction: Tetralogy of Fallot (TOF) is a cyanotic congenital heart disease that has an incidence of sudden cardiac death of 0.2% per year, being arrhythmias the main cause of its occurrence. Objective: To compare characteristics of TOF patients referred for electrophysiological study (EPS) against those that were not (No-EPS). Method: Retrospective cohort with 215 patients (57.2% men; age = 29 ± 4) with corrected TOF (median of three years, ranging from 0.33 to 51) that underwent EPS between 2009-2020. The primary outcome was composed of death, implantable cardiac defibrillator (ICD) requirement and hospitalization. Results: Pre-syncope (EPS = 4.7%, No-EPS = 0%; p = 0.004), syncope (EPS = 7.1%, No-EPS = 1.7%; p = 0.056) and palpitations (EPS = 31%, No-EPS = 5.8%; p < 0.001) were symptoms that justified electrophysiological investigation. ICD was implanted in 24% of EPS and 0.6% of No-EPS (p=0.001). Twenty-six percent of the EPS group presented non-sustained ventricular tachycardia, while 0% in No-EPS (p = 0.012). The EPS group had more atrial fibrillation or atrial Flutter (35.7% vs. 6.9%; p < 0.001). The EPS patients had a wider QRS duration than the no-EPS group (171.12 ± 29.52 ms vs. 147 ± 29.77 ms; p < 0.001). Also, 26.2% of EPS performed ablation to correct macroreentrant atrial tachycardias. The incidence of primary outcome (death + ICD requirement + hospitalization) was higher in patients in the EPS group compared to the No-EPS group (p = 0.001). However, the total of seven deaths occurred during the clinical follow-up, but without differences between the groups (EPS = 4.7% vs. No-EPS = 2.8%; p = 0.480). Conclusion: EPS group had a profile of greater risk, more complex heart disease, and a greater occurrence of the primary outcome when compared to the No-EPS group.

Joint language production: an electrophysiological investigation of simulated lexical access on behalf of task partner

This study investigates in a joint action setting a well-established effect in speech production, cumulative semantic interference, an increase in naming latencies when naming a series of semantically related pictures. In a joint action setting, two task partners take turns naming pictures. Previous work in this setting demonstrated that naming latencies increase not only with each semantically related picture speakers named themselves, but also with each picture named by the partner (Hoedemaker, Ernst, Meyer, & Belke, 2017; Kuhlen & Abdel Rahman, 2017). This suggests that speakers pursue lexical access on behalf of their partner. In two electrophysiological experiments (N=30 each) we investigated the neuro-cognitive signatures of such simulated lexical access. As expected, in both experiments speakers’ naming latency increased with successive naming instances within a given semantic category. Correspondingly, speakers’ EEG showed an increasing posterior positivity between 250-400ms, an ERP modulation typically associated with lexical access. However, unlike previous experiments, speakers were not influenced by their partner’s picture naming. Accordingly, we found no electrophysiological evidence of lexical access on behalf of the partner. We conclude that speakers do not always represent their partner’s naming response and discuss possible factors that may have limited the participants’ evaluation of the task as a joint action.