Accelerated Wean: A Novel 3 Day Berlin Heart Protocol in a Pediatric Patient.

We present the case of a 4 year old child who developed cardiogenic shock due to permanent junctional reciprocating tachycardia, requiring left ventricular assist device (LVAD) support. Despite the initial critical clinical presentation, successful myocardial recovery was achieved over 5 months, allowing for successful LVAD explantation. The patient's young age and behavioral issues were constraining factors for a prolonged LVAD wean trial.

Incidence and Outcomes of Iatrogenic Complete Atrioventricular Block After Congenital Heart Surgery.

Background: Iatrogenic complete atrioventricular block (ICAVB) has long been noted as a major complication after congenital heart surgery (CHS), and it contributes to complex postoperative care and potentially affects patients' outcomes.

Methods: This study is a retrospective review of the Pediatric Health Information System database from January 1, 2004 to September 30, 2023. All patients who underwent The Society of Thoracic Surgeons benchmark procedures were included.

Impact of electrophysiologists at daily multidisciplinary report in a paediatric cardiac care unit.

Background: Paediatric cardiac electrophysiologists are essential in CHD inpatient care, but their involvement is typically limited to consultation with individual patients. In our integrated heart centre, an electrophysiologist reviews all cardiac inpatient telemetry over the preceding 24 hours and participates in daily multidisciplinary morning report. This study investigates the impact of the strategy of consistent, formalised electrophysiologist presence at multidisciplinary morning report.

Pacemaker Management and In-Hospital Outcomes in Neonatal Congenital Atrioventricular Block.

Background: Neonatal congenital atrioventricular block (nCAVB) is rare, causes bradycardia, confers high mortality, and frequently requires pacing. In-hospital outcomes and pacemaker management in nCAVB are limited.

Objectives: The purpose of this study was to analyze pacing and outcomes of nCAVB with and without congenital heart disease (CHD) using a multicenter database.

Long QT and Hearing Loss in High-Risk Infants Prospective Study Registry.

The objective of this study is to determine the prevalence of an abnormal electrocardiogram showing a prolonged QTc greater than 450 ms in infants with unilateral or bilateral sensorineural hearing loss. We conducted a prospective study of healthy term infants (≥37 weeks gestational age) who failed their newborn auditory brainstem response hearing screen, were seen by an audiologist and diagnosed as having sensorineural hearing loss during follow-up to 1 year of age. In infants with a diagnosis of hearing loss, we collected a detailed family history and performed an ECG between 2 and 6 months of age.

Arrhythmias Requiring ECMO in Infants Without Structural Congenital Heart Disease.

Arrhythmias account for 55 per 100,000 patient evaluations in pediatric emergency departments. Most arrhythmias in children are amenable to medical management or cardioversion. Rarely, arrhythmias lead to significant hemodynamic instability requiring extracorporeal membrane oxygenation (ECMO) support.

Asymptomatic, transient complete heart block in a pediatric patient with Lyme disease.

Lyme Disease, caused by the spirochete Borrellia burgdorferi, is the most common vector-borne disease in the United States. Clinically, it primarily affects the skin, joints, nervous system, and heart. Lyme carditis occurs in 4%-10% of adults with Lyme disease.

Migration of an abandoned pacemaker generator into the pouch of Douglas in a child with complex congenital heart disease.

A young girl with complex congenital heart disease underwent Fontan procedure and multiple pacemaker revisions, including abandonment of an intraabdominal pacemaker generator at age eight. She presented two years later with constipation and abdominal twitching. Radiographs, pacemaker interrogation, and laparoscopy confirmed dislocation of the abandoned generator and intraperitoneal migration into the pouch of Douglas.

Military cardiology under a tent.

As Operation Iraqi Freedom enters its third year, the multinational military force remains engaged in a complex mission based on the military and political climate in the Middle East. As US Navy cardiologists deployed to Kuwait, our experiences proved diverse as we learned to practice in an austere environment. From the evaluation of chest pain to the treatment of coronary artery disease and arrhythmia, patient care was tempered by our ability to use our clinical acumen, physical exam and basic objective data to establish definitive dispositions.