Pediheart: Pediatric Cardiology Today

This week we enter the world of cardiogenetics and electrophysiology when we review the topic of catecholaminergic polymorphic ventricular tachycardia (CPVT). Is there a 'best' beta blocker for the treatment of this condition? Why is one better than others? How should one manage the patient who is intolerant of beta blockade but needs it for prevention of arrhythmia? What is the role of flecainide, sympathectomy or even ICD's for these patients? PhD candidate and physician Dr. Puck Peltenburg and CPVT world authority, Dr. Christian van der Werf (both of University of Amsterdam) share their deep insights this week. doi: 10.1161/CIRCULATIONAHA.121.056018. Epub 2021 Dec 7

This week we review a recent important work on outcomes of pregnancy in patients with bioprosthetic valves. What percentage of women entering pregnancy have a dysfunctional bioprosthetic valve? Is there a particular position of valve where the risk of dysfunction is greater for cardiac or fetal events? We speak with noted cardio-obstetrical expert, Dr. Barbara Wichert-Schmitt of Johannes Kepler University in Linz, Austria about her recent work from Canada. doi: 10.1016/j.jacc.2022.09.019

This week we review a recent report from the team at Children's National Hospital in Washington, DC on their experience with the hybrid approach to high risk infants with ductal-dependent systemic circulation. Some patients get ductal stents and others not. How is this decision made? How difficult was it to change the approach of a center that had a reputation for excellence with a more 'traditional/Norwood/Stage I palliative' approach? Are there theoretical advantages to this approach for even 'low risk' patients? We speak with the senior author of this report, Dr. Can Yerebakan who is Associate Professor of Surgery at George Washington University School of Medicine and Health Sciences. doi: 10.1016/j.jtcvs.2021.11.103

This week's episode focuses on gender disparities in salary in the field of congenital electrophysiology. To what degree are female electrophysiologists paid less than their male counterparts despite similar levels of education, work effort and seniority? What interventions could be enacted to help 'mind the gap' and level the playing field in this regard? We speak with the chief of pediatric electrophysiology at The Children's Hospital of Philadelphia, Professor Maully Shah, who is the first author of this week's research letter. doi: 10.1016/j.jacep.2022.02.011

This week we review a recent work from the Precision Medicine For Cardiomyopathy (PRIMaCY) study group on the role of stress testing in the pediatric HCM patient. Does stress testing help identify patients at risk for possible SCD or progression to heart transplantation? Should all pediatric HCM patients undergo this form of testing? What risks are associated with its use and how should these studies be performed? We speak with the first author of this novel multi center study, Associate Professor of Pediatrics Dr. Jennifer Conway of U. Alberta about this 'fresh off the presses' work. https://doi.org/10.1161/circulationaha.122.062699

In this week's replay of a most special 'fellow takeover episode', Dr. Sarah Pradhan, sometime co-host of Pediheart and interventional cardiology fellow at Toronto Sick Children's Hospital, speaks with Professor Roberta Williams of USC about her long and illustrious career as a pioneer in both echocardiography as well as pediatric cardiac critical care. Prepare for a lot of wisdom about career and life from this giant in the fields of pediatric cardiology and pediatrics.

This week we review a recent report from China on transcatheter closure of peri-membranous VSD's with the Amplatzer ADO II device. Reported results are outstanding and this week's report is one of several from China demonstrating efficacy and safety to this approach. Despite this, this procedure is rarely performed in the west. Why might that be? Do we need 'local data' to adopt an approach or can we proceed based upon data from another location where procedural indications may be different? We speak with the director of the cardiac catheterization laboratory at Cincinnati Children's Hospital, Dr. Shabana Shahanavaz about this question based upon her editorial on this impressive Chinese work. doi: 10.1161/JAHA.121.022651 and doi: 10.1161/JAHA.122.024963

This week we delve into the world of cardiac critical care when we review a recent report on an attempt to use a multidisciplinary group of hospital professionals plus parents to design an optimal family meeting structure. How should teams prepare for these meetings? What roles should different care providers play in the team meeting? Is there evidence that a better planned meeting can be more effective in transmitting information and allaying parental fears? We speak with pediatric palliative care expert, Assistant Professor of Pediatrics Dr. Jennifer Walter of The Children's Hospital of Philadelphia about this vital topic. https://doi.org/10.1016/j.jpainsymman.2022.03.010

This week we review a recent cardiac MRI report on Fontan geometry and hemodynamics as measured by computational fluid dynamic analysis. How do factors like Fontan geometry or 'power loss' relate to quality of life for the Fontan young adult patient? How do these data inform imaging in the operating room during these palliations? We speak with the first author of this work, Associate Professor of Pediatrics at U. Penn, Dr. Laura Mercer-Rosa about this important and intriguing work. https://doi.org/10.1016/j.athoracsur.2022.01.017

This week we review a recent international review on the topic of life threatening events occurring during electronic gaming. What risks do video games pose for the typical child or child with an arrhythmia condition? What precautions, if any, should be considered? Are there some sorts of games that are potentially more dangerous than others? We speak with the first and senior authors of this international survey - Dr. Claire M. Lawley of Great Ormand Street, London and Dr. Christian Turner of Sydney Children's Hospital in Sydney, Australia. doi: https://doi.org/10.1016/j.hrthm.2022.08.003.