Association Between COVID-19 and Orthostatic Intolerance in Children: A Retrospective Study.

Introduction SARS-CoV-2 infection (COVID-19) and the COVID-19 vaccine have been linked to the development of persistent symptoms, including orthostatic intolerance (OI) and postural orthostatic tachycardia syndrome (POTS), in both children and adults. POTS is characterized by excessive tachycardia and other symptoms upon standing, significantly impacting quality of life. This study aims to evaluate the clinical and laboratory findings in pediatric patients with post-COVID-19 or post-COVID-19 vaccine OI and POTS.

The Prevalence of Anxiety and Depression in Children With Postural Orthostatic Tachycardia Syndrome (POTS): A Retrospective Study.

Introduction: Postural orthostatic tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance characterized by various symptoms such as dizziness, lightheadedness, and increased heart rate. Conflicting reports exist regarding the prevalence of anxiety and depression in adults with POTS, while data on pediatric POTS remains scarce.

Method: A retrospective analysis of pediatric patients aged 11-17 years with POTS, who underwent autonomic testing at Nemours Children's Hospital in Orlando, Florida, was conducted.

Comprehensive linear and nonlinear heart rate variability normative data in children.

Background: The autonomic nervous system (ANS) is critical in regulating involuntary bodily functions, including heart rate. Heart rate variability (HRV) reflects the complex interplay between the ANS and humoral factors, making it a valuable noninvasive tool for assessing autonomic function. While HRV has been extensively studied in adults, normative data for HRV in children, primarily based on long-term rhythm recordings, are limited.

Median Arcuate Ligament Syndrome in Children: A Single-Center Experience.

Background: Data on median arcuate ligament syndrome (MALS) in children are scant. It is postulated that MALS can cause chronic abdominal pain. It is unclear what percentage of children with this condition are symptomatic and what comorbidities are associated with this syndrome.

Prevalence and Risk Factors for Tube-Feeding at Discharge in Infants following Early Congenital Heart Disease Surgery: A Single-Center Cohort Study.

Objective: Oral feeding difficulty is common in infants after congenital heart disease (CHD) surgical repair and is associated with prolonged hospital stay and increased risk for tube-feeding at discharge (TF). The current understanding of the enteropathogenesis of oral feeding difficulty in infants requiring CHD surgery is limited. To determine the prevalence and risk factors for TF following CHD surgery in early infancy.

The Effect of Cardiac Mass and Venous Return in Children with Postural Orthostatic Tachycardia Syndrome: A Prospective, Observational Study.

Low left ventricular mass index (LVMI) is thought to limit exercise tolerance in adult patients with postural orthostatic tachycardia syndrome (POTS). This finding has not been studied in children. We evaluated the effect of LVMI and hemodynamics at baseline and during exercise in POTS versus controls.

Extraction of Peak Velocity Profiles from Doppler Echocardiography Using Image Processing.

The objective of this study is to extract positive and negative peak velocity profiles from Doppler echocardiographic images. These profiles are currently estimated using tedious manual approaches. Profiles can be used to establish realistic boundary conditions for computational hemodynamic studies and to estimate cardiac time intervals, which are of clinical utility.

Development of quality metrics for ambulatory pediatric cardiology: Chest pain.

Objective: As part of the American College of Cardiology Adult Congenital and Pediatric Cardiology Section effort to develop quality metrics (QMs) for ambulatory pediatric practice, the chest pain subcommittee aimed to develop QMs for evaluation of chest pain.

Design: A group of 8 pediatric cardiologists formulated candidate QMs in the areas of history, physical examination, and testing. Consensus candidate QMs were submitted to an expert panel for scoring by the RAND-UCLA modified Delphi process.

A Practical ECG Criterion to Unmask Left Accessory AV Connections in Patients With Subtle Preexcitation.

Background: Accessory AV-connections capable of antegrade conduction need to be recognized because of the potential for life-threatening arrhythmias. However, the preexcited ECG pattern may be subtle, especially among left-sided AV-connections. We explored whether additional ECG criteria might help identify left-sided AV-connections.

Prolonged electrical quiescence after direct current cardioversion for atrial flutter in congenital heart disease.

Elective direct current cardioversion is considered first-line treatment in many cases of atrial flutter and fibrillation. This also is true in the pediatric population. This report describes a case of successful cardioversion that resulted in a very prolonged electrical quiescence.

Is there an association between external cardioversions and long-term mortality and morbidity? Insights from the Atrial Fibrillation Follow-up Investigation of Rhythm Management study.

Background: Cardiac electric therapies effectively terminate tachyarrhythmias. Recent data suggest a possible increase in long-term mortality associated with implantable cardioverter-defibrillator shocks. Little is known about the association between external cardioversion episodes (ECVe) and long-term mortality.

Surgical electrocautery facilitated transseptal puncture in children.

Background: Transseptal puncture has been performed in adults and children for decades. However, transseptal puncture can be challenging especially in pediatric patients because of an elastic septum and small atria. In adults, dedicated radiofrequency (RF) to facilitate transseptal puncture has become routine.

Inside-out access: a new method of lead placement for patients with central venous occlusions.

Background: Physicians will increasingly encounter patients who require rhythm management devices but have venous obstructions that prevent conventional access. Alternate access options, such as thoracotomy or transiliac approaches, exist but are associated with greater cost and morbidity.

Objective: The purpose of this study is to describe a novel method of vascular access that allows prepectoral placement of conventional pacing and defibrillation leads in patients with complex central venous occlusions.

Frequent ventricular premature beats in children with a structurally normal heart: a cause for reversible left ventricular dysfunction?

Ventricular premature beats (VPBs) in a structurally normal heart generally are a benign condition. Rarely, however, reversible cardiomyopathy may develop. This study aimed to evaluate the incidence of cardiomyopathy among pediatric patients in a cohort with frequent VPBs and to examine the characteristics of the ventricular ectopic beats as well as therapeutic options.

Pediatric nonpost-operative junctional ectopic tachycardia medical management and interventional therapies.

Objectives: To determine the outcomes of medical management, pacing, and catheter ablation for the treatment of nonpost-operative junctional ectopic tachycardia (JET) in a pediatric population.

Background: Nonpost-operative JET is a rare tachyarrhythmia that is associated with a high rate of morbidity and mortality. Most reports of clinical outcomes were published before the routine use of amiodarone or ablation therapies.

Successful management of acute failure of the systemic right ventricle with cardiac resynchronization therapy.

Management of systemic right ventricular (RV) failure can be challenging. Anatomical abnormality due to congenital heart disease adds to the complexity when interventions are performed. We report a patient with acute systemic RV failure who was successfully managed with cardiac resynchronization therapy.

Complete occlusion of the left circumflex coronary artery after radiofrequency catheter ablation in an infant.

Radiofrequency catheter ablation of a left lateral accessory atrioventricular pathway was performed in a 5-week-old infant with drug-refractory supraventricular tachycardia. Energy application via a 5-French mapping and ablation catheter in the temperature-controlled mode (60 degrees C, 30 W) at the atrial aspect of the mitral valve annulus repeatedly resulted in termination of the tachycardia by conduction block within the pathway. Tachycardia remained inducible subsequently.