Cardiac Arrhythmia in Pediatric Heart Patients Using Ventricular Assist Devices
June 9, 2022
A research team from the Heart Institute at UPMC Children’s Hospital of Pittsburgh published new findings on the prevalence and characteristics of cardiac arrhythmia in pediatric patients with an implanted ventricular assist device. The study was published in May 2022 in the journal Circulation: Heart Failure online ahead of print and constitutes the largest study published to date on arrhythmia in pediatric patients with a ventricular assist device.
Cardiology fellow Anthony Pompa, MD, was the study’s lead author. Gaurav Arora, MD, associate director of electrophysiology, was the senior author. Also contributing to the study were Lee Beerman, MD, director of the Electrophysiology Services and Pediatric Arrhythmia Program at UPMC Children’s; Brian Feingold, MD, MS, FAHA, medical director of the Heart Failure and Transplantation Programs at UPMC Children’s; and Matthew Zinn, DO, medical director of the Ventricular Assist Device Program at UPMC Children’s.
Study Overview and Highlights
The study examined the incidence and nature of arrhythmia in pediatric patients less than 21 years of age with a ventricular assist device (VAD) seen at UPMC Children’s between September 2004 and June 2020.
That analysis covers 99 implanted VADs in 74 unique patients. The majority of patients, 74%, had VADs implanted for cardiomyopathy. The remaining patients consisted of congenital heart disease diagnoses — 19% — and myocarditis — 4%.
The team found that 47% of VAD patients (n=35) suffered some form of arrhythmia during their VAD therapy, but all of the patients who had an arrhythmia only had one kind. The types of arrhythmias identified in this patient cohort were sustained ventricular tachycardia (n=5); nonsustained ventricular tachycardia (n=25); atrial flutter (n=3); and atrial tachycardia (n=2).
Patients diagnosed with cardiomyopathy or myocarditis were found to be at higher risk for developing an arrhythmia during VAD therapy and more prone to experiencing an abnormal rhythm earlier in VAD therapy, when compared to patients with congenital heart disease.
Patients who experienced an arrhythmia during VAD therapy were found to have a mean time to initial occurrence of 8.5 days.
Results from this study should spur additional research into the nature of cardiac rhythm disturbances in pediatric patients and how to better predict or prevent their occurrence or optimally manage arrhythmias in this patient population when they do occur.
Learn more about the Heart Institute at UPMC Children’s Hospital of Pittsburgh.
Reference
Pompa AG, Beerman LB, Feingold B, Zinn MD, Arora G. Arrhythmia Burden in Pediatric Patients With a Ventricular Assist Device. Circ Heart Fail. 2022 May 20; 101161CiRCHEARTFAILURE122009566. Online ahead of print.
