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Variations in cardiac implantable electronic device surveillance and ancillary testing in the paediatric and congenital heart disease population: an international multi-centre survey from the Paediatric and Congenital Electrophysiology Society

Published online by Cambridge University Press:  28 October 2021

Melissa M. Olen
Affiliation:
Division of Cardiology, Nicklaus Children’s Hospital, Miami, FL, USA
Brynn E. Dechert
Affiliation:
C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
Anne Foster
Affiliation:
Division of Cardiology, Advocate Children’s Heart Institute, Oak Lawn, IL, USA
Ronald J. Kanter
Affiliation:
Division of Cardiology, Nicklaus Children’s Hospital, Miami, FL, USA
Michael J. Silka
Affiliation:
Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA, USA
Maully J. Shah*
Affiliation:
Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
*
Author for correspondence: M. Shah, MBBS, Director, Cardiac Electrophysiology, The Cardiac Center, The Children’s Hospital of Philadelphia, 3400 Civic Center Boulevard, Philadelphia, PA 19104, USA. Tel: +2674256603; Fax: +215 590 3267. E-mail: Shahm@chop.edu

Abstract

Background:

Expert guidance from scientific societies and regulatory agencies recommend a framework of principles for frequency of in-person evaluations and remote monitoring for patients with cardiac implantable electronic devices. However, there are limited data regarding adherence to recommendations among paediatric electrophysiologists, and there are no data regarding cardiac implantable electronic device-related ancillary testing.

Methods:

To assess current clinical practices for cardiac implantable electronic device in-person evaluation, remote monitoring, and cardiac implantable electronic device-related ancillary testing, the Paediatric and Congenital Electrophysiology Society members were surveyed. The main outcome measures were variations in frequency of in person evaluation, frequency of remote monitoring, and cardiac implantable electronic device-related ancillary testing.

Results:

All respondents performed in-person evaluation at least once a year, but <50% of respondents performed an in-person evaluation within 2 weeks of cardiac implantable electronic device implantation. Remote monitoring was performed every 3 months for pacemakers and implantable cardioverter defibrillators by 71 and 75% respondents, respectively. Follow-up echocardiography was performed every 2–3 years by 53% respondents for patients with >50% ventricular pacing. Majority of respondents (75%) did not perform either an exercise stress test or ambulatory Holter monitoring or chest X-ray (65%) after cardiac implantable electronic device implantation.

Conclusion:

This survey identified significant practice variations in cardiac implantable electronic device in- person evaluation, remote monitoring, and ancillary testing practices among paediatric electrophysiologists. Cardiac implantable electronic device management may be optimised by development of a paediatric-specific guidelines for follow-up and ancillary testing.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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References

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Variations in cardiac implantable electronic device surveillance and ancillary testing in the paediatric and congenital heart disease population: an international multi-centre survey from the Paediatric and Congenital Electrophysiology Society
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