Tetrology of Fallot (TOF) is the most common cyanotic congenital heart disease, accounting for 10% of all types of congenital heart disease. Despite decreased mortality rates by improvement in surgery and post-cardiac intensive care, there continues to be late postoperative complications. This study aimed to evaluate the outcomes after total repair of tetralogy of Fallot, including 44 children who underwent complete surgical repair between 2000 to 2018. Data were collected from medical records and directly from patients during their visit to the clinic, that included: history, clinical examination, gender, age at operation, results of ECG, Holter monitoring, echocardiography, cardiac catheterization, cardiac CT scan. Follow-up ranged from 6 months to18 years. Results revealed that the M/F ratio was 1.4:1. Also, two patients had a previous palliative systemic artery to PA shunt. A TAP was inserted in 22 (50%) patients. Postoperative complications were: severe PR 29%, small residual VSD 18.1%, and two patients had significant VSD which needed surgical intervention, residual RVOT 8.1%, RBBB 97.7%, There was three death (6.8%), and 36.3% of patients will need surgical intervention in the future. It was concluded that follow-ups up to adulthood to monitor potential complications are necessary. QRS duration is used for monitoring ventricular arrhythmia and sudden death. Echocardiography is a non-invasive tool in diagnosis, before and at the time of surgery, as well as in follow-ups.

Aims: To recognize cardiac arrhythmias and conduction abnormalities in children who underwent a surgical repair for congenital heart disease. Patients and Methods: One hundred thirty one (131) patients underwent a surgical repair of congenital heart disease between 2000-2018, and follow-up period after surgery was from two months to eighteen years and our data was collected over 1 year “2018”  by interview both children and parents, sixty-four patients (48.8%) were a cyanotic congenital heart disease (ACCHD),sixty-seven patients(51.1%) were cyanotic congenital heart disease (CCHD), (41.9%) were female, (58.1%) were male. Cyanotic congenital heart disease more common in male. These patients were evaluated by ECG to detect conduction abnormalities and arrhythmias, Holter monitoring in symptomatic patient. Results: Types of abnormal heart rhythm found out by ECG, Holter monitoring, significant premature atrial contraction (PAC) in one patient post fontain, atrial fibrillation in two patients with post-operative (ASD) repaired. RBBB occur in 53 patients and was most common among post-operative (TOF) repaired (37 patients). Frequent ventricular ectopic in one patient with postoperative (TOF) repaired. Atrial tachycardia in one patient with Epstein anomaly, WPW in two patients with Epstein anomaly, complete heart blook in five patients, four of them post operative VSD repaired, one post fontain operation. Symptomatic bradycardia needs pace maker in one patient post fontan operation. Conclusions: The Patient after repair of congenital heart defect needed follow-up for detection of arrhythmias, those with complex defect need more frequent follow-up because they prone more to arrhythmia than those with simple defect with no residual defect.