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Rückert J, Michaelis A, Markel F, Kalden P, Löffelbein F, Klehs S, Dähnert I, Schöffl I, Rottermann K, Paech C. Open Field Exercise Testing in Pediatric Congenital Heart Disease Patients: A Subsumption of Cardiovascular Parameters. Pediatr Cardiol 2023; 44:1831-1838. [PMID: 37486362 PMCID: PMC10520100 DOI: 10.1007/s00246-023-03226-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/02/2023] [Indexed: 07/25/2023]
Abstract
Heart failure is a common phenomenon in congenital heart disease patients. Cardiopulmonary exercise testing is used for a reliable assessment of heart failure but is still challenging, especially for young children. Implementing mobile cardiopulmonary exercise testing (CPET) can close that diagnostic gap. While average values for healthy children have already been published, this study aims to describe typical ranges of cardiovascular performance parameters of young children with congenital heart disease performing an 8-min running cardiopulmonary exercise test. Children aged 4-8 years with common congenital heart defects after corrective surgery (Tetralogy of Fallot; transposition of the great arteries and univentricular hearts after palliation) were included. The outdoor running protocol consisted of slow walking, slow jogging, fast jogging, and maximum speed running. Each exercise was performed for 2 min, except the last, in which children were instructed to keep up maximal speed as long as possible. A total of 78 children (45 male/33 female, mean age 6,24) with congenital heart disease participated in the study, of which 97% completed the CPET successfully. A detailed description of participating patients, including data on cardiac function and subjective fitness levels, is given to help physicians use this method to classify their patients. This study presents a typical range for cardiovascular performance parameters in a population of 4-8-year-old children with congenital heart disease tested in a newly developed outdoor running protocol for CPET.
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Affiliation(s)
- J. Rückert
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - A. Michaelis
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - F. Markel
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - P. Kalden
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - F. Löffelbein
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - S. Klehs
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - I. Dähnert
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
| | - I. Schöffl
- Department of Pediatric Cardiology, University Hospital Erlangen, Loschbergstraße 15, 91054 Erlangen, Germany
| | - K. Rottermann
- Department of Pediatric Cardiology, University Hospital Erlangen, Loschbergstraße 15, 91054 Erlangen, Germany
| | - C. Paech
- Department for Pediatric Cardiology, University of Leipzig - Heart Center, Strümpellstr. 39, 04289 Leipzig, Germany
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Klehs S, Schneider HE, Backhoff D, Müller MJ, Paul T, Krause U. Repeat Radiofrequency Catheter Ablation of Atrial Tachycardias in Patients with Congenital Heart Disease. J Cardiovasc Electrophysiol 2022; 33:943-952. [PMID: 35199408 DOI: 10.1111/jce.15422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/07/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Atrial tachycardias (AT) in patients with congenital heart disease (CHD) are significantly contributing to morbidity and mortality. Aim of this study was to evaluate the long-term course of CHD patients requiring repeat ablation procedures (RAP) of AT. PATIENTS AND METHODS All 144 patients with CHD who had undergone ablation of AT at our center between January 2003 and October 2018 were enrolled. Patients were classified according to complexity of CHD: complex CHD (cCHD), moderate CHD (mCHD) and simple CHD (sCHD). RESULTS A total of 101 RAP were performed in 64 patients. One RAP was performed in n=40, two in n=13, three in n=10 and 5 in n=1. Acute success rate was 82% (83/101) and was not associated with complexity of CHD (p=1.0). Number of procedures was lower in patients with sCHD than in patients with mCHD and cCHD (sCHD 1.3±0.6, mCHD 1.8±1.0 and cCHD 1.8±1.1, p=0.04). RAP were most frequent in patients after Fontan palliation or Atrial switch procedure (2.0±1.1 (n=41) vs. 1.6±0.9 all others, p=0.016) and in patients with multiple unstable AT´s (2.5±1.1 (n=11) vs. 1.7±1.0, p=0.008). Major complications occurred in 4/101 procedures. Complete follow-up was available in 125 patients. Since last RAP 73% of the patients were in sinus/atrial rhythm and 34/125 patients (27%) with AT recurrence did not require re-ablation with mean follow-up of 52±40 months. CONCLUSIONS Recurrences after ablation of AT in CHD patients were frequent. After RAP promising long-term results could be achieved. Data encourage repetitive ablation procedures in this patient population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- S Klehs
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - H E Schneider
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - D Backhoff
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - M J Müller
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - T Paul
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
| | - U Krause
- Department of Pediatric Cardiology and Intensive Care Medicine, University Medical Center, Georg-August-University Göttingen
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Klehs S, Wolff M, Wagner F, Bertagnolli L, Paech C, Gebauer R. Coherent Mapping of Atrial Tachycardias in Patients with Congenital Heart Disease. Thorac Cardiovasc Surg 2022. [DOI: 10.1055/s-0042-1743030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S. Klehs
- Herzzentrum Leipzig, Leipzig, Deutschland
| | - M. Wolff
- Johnson & Johnson Medical Ltd., Leipzig, Deutschland
| | - F. Wagner
- Herzzentrum Leipzig, Leipzig, Deutschland
| | | | - C. Paech
- Herzzentrum Leipzig, Leipzig, Deutschland
| | - R. Gebauer
- Herzzentrum Leipzig, Leipzig, Deutschland
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Klehs S, Schneider H, Backhoff DJ, Müller M, Paul T, Krause U. Long-Term Follow-up after Radiofrequency Catheter Ablation of Atrial Tachycardias in Patients with Congenital Heart Disease. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Backhoff D, Klehs S, Müller M, Schneider H, Paul T, Krause U. Long-Term Follow-up after Catheter Ablation of Accessory Pathways in Children. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1598977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- D. Backhoff
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University of Göttingen, Göttingen, Germany
| | - S. Klehs
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University of Göttingen, Göttingen, Germany
| | - M.J. Müller
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University of Göttingen, Göttingen, Germany
| | - H.E. Schneider
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University of Göttingen, Göttingen, Germany
| | - T. Paul
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University of Göttingen, Göttingen, Germany
| | - U. Krause
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University of Göttingen, Göttingen, Germany
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Backhoff D, Klehs S, Müller M, Schneider H, Kriebel T, Paul T, Krause U. Long-Term Follow-up after Catheter Ablation of AV Nodal Reentrant Tachycardia in Children. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Krause U, Abreu da Cunha F, Backhoff D, Jacobshagen C, Klehs S, Schneider H, Paul T. Effects of Triple Cryoenergy Application on Early Lesion Formation and Coronary Arteries in the Developing Myocardium. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Klehs S, Dieks J, Müller M, Paul T, Krause U. Ivabradine: A Useful Agent for Treatment of Congenital Junctional Ectopic Tachycardia. Thorac Cardiovasc Surg 2016. [DOI: 10.1055/s-0036-1571889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Klehs S, Schneider H, Kriebel T, Backhoff D, Paul T, Krause U. Catheter Ablation of Atrial Reentry Tachycardia in Patients with Congenital Heart Disease—Efficacy and Safety. Thorac Cardiovasc Surg 2015. [DOI: 10.1055/s-0035-1556005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Backhoff D, Krause U, Schneider H, Müller M, Klehs S, Kriebel T, Paul T. Catheter ablation of accessory atrioventricular pathways in children and adolescents - weight matters. Thorac Cardiovasc Surg 2014. [DOI: 10.1055/s-0034-1393978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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