Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
1.
Cardiol Young ; 32(1): 101-105, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34709146

RESUMO

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.


Assuntos
Desfibriladores Implantáveis , Cardiopatias Congênitas , Marca-Passo Artificial , Eletrofisiologia Cardíaca , Criança , Eletrônica , Cardiopatias Congênitas/diagnóstico , Cardiopatias Congênitas/terapia , Humanos , Inquéritos e Questionários
2.
Cardiol Young ; 27(S1): S143-S146, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28084972

RESUMO

Remote monitoring in the modern era has improved outcomes for patients with cardiac implantable electronic devices. There are many advantages to remote monitoring, including improved quality of life for patients, decreased need for in-office interrogation, and secondary reduced costs. Patient safety and enhanced survival remain the most significant benefit. With most of the published literature on this topic being focussed on adults, paediatric outcomes continue to be defined. This is a review of the benefits of remote monitoring in paediatrics and in patients with CHD.


Assuntos
Desfibriladores Implantáveis , Cardiopatias Congênitas/terapia , Monitorização Fisiológica/métodos , Marca-Passo Artificial , Qualidade de Vida , Telemedicina/estatística & dados numéricos , Análise Custo-Benefício , Humanos , Monitorização Fisiológica/economia , Pediatria
3.
Cardiol Young ; 27(4): 648-662, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27373527

RESUMO

Over the past 20 years, the successes of neonatal and infant surgery have resulted in dramatically changed demographics in ambulatory cardiology. These school-aged children and young adults have complex and, in some cases, previously unexpected cardiac and non-cardiac consequences of their surgical and/or transcatheter procedures. There is a growing need for additional cardiac and non-cardiac subspecialists, and coordination of care may be quite challenging. In contrast to hospital-based care, where inpatient care protocols are common, and perioperative expectations are more or less predictable for most children, ambulatory cardiologists have evolved strategies of care more or less independently, based on their education, training, experience, and individual styles, resulting in highly variable follow-up strategies. We have proposed a combination proactive-reactive collaborative model with a patient's primary cardiologist, primary-care provider, and subspecialists, along with the patient and their family. The goal is to help standardise data collection in the ambulatory setting, reduce patient and family anxiety, increase health literacy, measure and address the non-cardiac consequences of complex cardiac disease, and aid in the transition to self-care as an adult.


Assuntos
Assistência Ambulatorial/métodos , Assistência Ambulatorial/normas , Cardiopatias Congênitas/cirurgia , Adolescente , Cardiologia/educação , Serviço Hospitalar de Cardiologia , Criança , Humanos , Estados Unidos , Adulto Jovem
4.
Pacing Clin Electrophysiol ; 38(2): 209-15, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25469902

RESUMO

BACKGROUND: Catheter ablation of idiopathic left ventricular tachycardia in the pediatric population remains challenging. A recent multicenter study reported limited success with 14% not undergoing ablation due to inability to induce ventricular tachycardia (VT) or blood pressure instability during tachycardia. Creating complete or partial fascicular block with radiofrequency catheter ablation is a technique that may eliminate VT. This approach is performed during sinus rhythm, enabling atrioventricular conduction monitoring and maintaining stable hemodynamics. Importantly, induction of VT is not necessary for mapping or assessing efficacy of the procedure. METHODS: A retrospective review of pediatric patients (3-17 years) with recurrent, documented idiopathic left ventricular tachycardia by electrocardiogram who received catheter ablation by creating fascicular block as a therapeutic endpoint was performed. All had ablation at the site of an identified Purkinje potential. RESULTS: There were six patients with idiopathic left ventricular tachycardia, five originating from the posterior fascicle and one from the anterior fascicle. VT was not induced or spontaneous in four patients using programmed stimulation and isoproterenol infusion. All patients had a QRS axis shift following ablation, though none met criteria for fascicular block. At follow up (7-49 months, mean 27 months), all patients had persistence of this shift. There were no recurrences of VT and none of the patients were taking antiarrhythmic medication. CONCLUSION: The technique of creating partial fascicular block appears to be a safe and effective approach to ablation of idiopathic left ventricular tachycardia in children.


Assuntos
Bloqueio de Ramo/cirurgia , Ablação por Cateter/métodos , Sistema de Condução Cardíaco/cirurgia , Bloqueio Nervoso/métodos , Taquicardia Ventricular/cirurgia , Disfunção Ventricular Esquerda/cirurgia , Adolescente , Bloqueio de Ramo/complicações , Bloqueio de Ramo/diagnóstico , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Taquicardia Ventricular/complicações , Taquicardia Ventricular/diagnóstico , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/etiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA