Utility and Safety of Combined Interventional Catheterization and Electrophysiology Procedures in a Children's Hospital.

BACKGROUND: Interventional cardiac catheterization (cath) and electrophysiology (EP) procedures are not routinely performed together. There are several perceived barriers affecting this practice, though there are also advantages for both the patient and practitioner to a combined approach. METHODS: This was a single-center retrospective study reviewing combined cath and EP procedures with a preprocedural intention to intervene at Texas Children's Hospital from 2001 to 2014. We excluded procedures in which the intended procedure was purely diagnostic in nature. RESULTS: A total of 121 patients requiring 125 procedures were identified, of which 61 patients underwent 62 procedures that met our inclusion criteria. Potential subgroups of interest included adult congenital heart disease patients (26% of cohort), single ventricle anatomy (34%), and heterotaxy (19%) and collectively 58% of procedures involved a patient in one of these groups. The combined nature of the procedure did not preclude a cath or EP intervention in any patient. There were no mortalities. There were three adverse events, affecting 4.8% of procedures. CONCLUSIONS: Combined interventional cardiac cath and EP procedures in pediatric patients and those with congenital heart disease can be performed safely in a high-volume center. These combined procedures save patients the risk and inconvenience of multiple procedures, and further investigation into cost savings is warranted.

Disparities Regarding Inadequate Automated External Defibrillator Training and Potential Barriers to Successful Cardiac Resuscitation in Public School Systems.

Installation of automated external defibrillators (AEDs) in public schools has been shown to improve outcomes for children with sudden cardiac arrest (SCA). However, the adequacy of faculty AED training and potential barriers to successful cardiac resuscitation remain unknown. A questionnaire was mailed to all public schools in the state of Illinois (n = 3796). The survey focused on the demographic variables of each school as well as the confidence of the responder regarding effectiveness of AED training. 2,192 surveys were included in this study (58% response rate). Independent variables for perceived inadequate AED training were schools that were predominantly black (odds ratio [OR] 3.93; 3.01 to 5.13) or Hispanic (OR 2.75; 2.11 to 3.58), elementary schools (OR 2.05; 1.69 to 2.50), schools with <250 students (OR 1.69; 1.19 to 2.40) and <25 faculty (OR 1.54; 1.10 to 2.15). Eighty-eight percent of responders cited at least one barrier to successful AED utilization. Location in a town setting (OR 9.34; 4.73 to 18.44) or rural setting (OR 3.18; 2.47 to 4.10) as well as upper socioeconomic status (OR 3.85; 2.04 to 7.29) were found to be predictors of schools with no barriers to AED utilization.