Moderate complexity congenital heart disease is de- fined as congenital heart disease requiring intracardiac surgical repair, other than isolated atrial and ventricular septal defects; includes TOF, aortic stenosis, coarctation of aorta, and Ebstein anomaly of the tricuspid valve. Severe complexity congenital heart disease is defined as cyanotic congenital heart disease requiring intracar- diac repair in infancy, often with staging procedures; includes transposition of the great arteries, truncus ar- teriosus, and single ventricle anatomy (Figure 16). Recommendation-Specific Supportive Text 1. The association of VT with RV hemodynamic abnormalities was first established in patients with repaired TOF.S10.8-33 Multiple studies since that time have demonstrated the correlation of hemodynamic residue and ventricular dysfunction with risk of VT or SCD in patients with congeni- tal heart disease.S10.8-1,S10.8-3 S10.8-6,S10.8-18,S10.8-34 S10.8-36 Presentation with frequent or complex VA may indicate worsening hemodynamic function, coro- nary artery compromise, or decreased perfusion in the setting of ventricular hypertrophy. Evaluation may also include exercise testing to assess func- Careful evaluation of hemo- dynamic status for optimization of management Potentially treatable residual hemodynamic problems may be identified dur- ing hemodynamic evaluation, such as outflow tract stenosis or significant regurgitation, which may benefit from either catheter or surgical Patients with markedly reduced ventricular function, elevated end-diastolic pressures, or pulmonary hypertension should be treated for underlying hemodynamic problems as part of their arrhyth- mia management. 2. 