Alicia Williams, Amy E Cassedy, Pooja Parikh, Clayton D Hinkle, Amy Moravec, Sarah G Rose, Kiona Y Allen, Bradley S Marino
{"title":"Prevalence of Post-Intensive Care Syndrome in Paediatrics in children with CHD and association with health-related quality of life outcomes.","authors":"Alicia Williams, Amy E Cassedy, Pooja Parikh, Clayton D Hinkle, Amy Moravec, Sarah G Rose, Kiona Y Allen, Bradley S Marino","doi":"10.1017/S1047951126123543","DOIUrl":"https://doi.org/10.1017/S1047951126123543","url":null,"abstract":"<p><strong>Introduction: </strong>Children with CHD require ICU admissions, putting them at risk for Post-intensive Care Syndrome in Paediatrics defined as physical, cognitive, social, and emotional health impairments following ICU discharge. There are few studies assessing Post-intensive Care Syndrome in Paediatrics in the CHD population. This study assessed the presence of Post-intensive Care Syndrome in Paediatrics in the CHD community and its relationship with health-related quality of life.</p><p><strong>Methods: </strong>CHD patients 5-18 years having 1 or more cardiac ICU admissions were evaluated in the Newborn ICU-Cardiac Neurodevelopmental Program from 9/2017 to 9/2020. Physical, cognitive, social, and emotional questionnaires measured each domain. Patients were considered impaired if 2 or more domain questionnaires were abnormal. If any domain showed impairment, Post-intensive Care Syndrome in Paediatrics was present. Predictors included demographic, disease severity, and ICU variables. Health-related quality of life was measured using the Paediatric Cardiac Quality of Life Inventory. Models were created using logistic and linear regression.</p><p><strong>Results: </strong>Of the 117 CHD patients, 50% were male having a mean age of 8.4 and a 5 year median time since last ICU admission. Post-Intensive Care syndrome in Pediatrics was found in 80% of the cohort: 36% physical, 70% cognitive, 26% social, and 33% emotional impairment. Patients with a longer time since last ICU admission showed less physical and emotional impairment (<i>p</i> < 0.05) with emotional impairment associated with worse health-related quality of life (<i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Post-intensive Care Syndrome in Paediatrics was present in most CHD patients. Worse emotional health was associated with lower health-related quality of life.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1-10"},"PeriodicalIF":0.8,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-06-25DOI: 10.1017/S104795112611381X
Ken Hayashi, Kumiyo Matsuo, Hisaaki Aoki
{"title":"Transcatheter intervention for bilateral patent ductus arteriosus with isolated left brachiocephalic artery.","authors":"Ken Hayashi, Kumiyo Matsuo, Hisaaki Aoki","doi":"10.1017/S104795112611381X","DOIUrl":"10.1017/S104795112611381X","url":null,"abstract":"<p><p>In cases of isolated left brachiocephalic artery, if both ductus arteriosus remain patent, excessive pulmonary blood flow can occur, and cerebral perfusion may be compromised by a steal phenomenon, potentially leading to cerebral atrophy. We report a case of an isolated left brachiocephalic artery with bilateral patent ductus arteriosus in which transcatheter closure of both ductus arteriosus was successfully performed.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1536-1539"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148315793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-06-29DOI: 10.1017/S1047951126111937
Mustafa Argun, Gökçe Nur Yıldızoğulları, Gözde Karaçelik, Kübra Yörük, Esra Nur Kaya, Hatice Kübra Konak, Mehmet Zahid Takcı, Mansur Kızıltuğ, Mehmet Akif Dündar, Suleyman Sunkak, Ferhan Elmalı, Nazmi Narin
{"title":"Prone back electrocardiogram in healthy children: comparison with routine supine electrocardiogram.","authors":"Mustafa Argun, Gökçe Nur Yıldızoğulları, Gözde Karaçelik, Kübra Yörük, Esra Nur Kaya, Hatice Kübra Konak, Mehmet Zahid Takcı, Mansur Kızıltuğ, Mehmet Akif Dündar, Suleyman Sunkak, Ferhan Elmalı, Nazmi Narin","doi":"10.1017/S1047951126111937","DOIUrl":"10.1017/S1047951126111937","url":null,"abstract":"<p><strong>Background: </strong>In children, oxygen support in the prone position may be preferred for certain conditions such as acute respiratory distress syndrome. However, it is very difficult to place such patients in the supine position to obtain an electrocardiogram. We aimed to determine the effectiveness of prone back 12-lead electrocardiogram and detect electrocardiogram changes in healthy children.</p><p><strong>Methods: </strong>The present study comprised 50 healthy children aged between 3 and 7 years. The patients first underwent a supine electrocardiogram test used in routine practice. Back electrocardiogram in prone position was obtained by placing six of the precordial leads (prone V1-prone V6) to the back of the patient.</p><p><strong>Results: </strong>The average P wave, Q wave, R wave, S wave, and T wave amplitudes were significantly smaller in prone back leads (prone V1-prone V5) compared to supine precordial leads (supine V1-supine V5) (<i>p</i> < 0.001). The only exceptions were that the mean T wave amplitude in prone V3 and supine V3 was similar, and the mean Q wave amplitude in prone V5 and supine V5 was similar. The average P wave, Q wave, S wave, and T wave amplitudes were similar when prone V6 was compared with supine V6.</p><p><strong>Conclusion: </strong>A back electrocardiogram in the prone position is a useful and practical approach that provides valuable information to the clinician.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1469-1478"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148343925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-07-06DOI: 10.1017/S1047951126113900
Bibhuti Das, Manikum Moodley
{"title":"Post-COVID paediatric dysautonomia: never the heart, always the brain-myth or maxim?","authors":"Bibhuti Das, Manikum Moodley","doi":"10.1017/S1047951126113900","DOIUrl":"10.1017/S1047951126113900","url":null,"abstract":"<p><p>Paediatric dysautonomia has become increasingly recognised in children and adolescents, particularly in the post-COVID era. Affected patients commonly present with dizziness, palpitations, exercise intolerance, fatigue, and syncope, although reported prevalence varies widely because of evolving definitions and heterogeneous referral patterns. Contemporary evidence suggests that post-COVID dysautonomia arises from complex interactions among central autonomic network dysfunction, neurovascular dysregulation, impaired venous return, endothelial injury, hypovolemia, and altered cerebral perfusion, with tachycardia often representing a compensatory physiological response rather than a primary cardiac abnormality. Clinical phenotypes include postural orthostatic tachycardia syndrome, neurocardiogenic syncope, orthostatic hypotension, inappropriate sinus tachycardia, and undifferentiated orthostatic intolerance, frequently accompanied by fatigue, cognitive dysfunction, gastrointestinal symptoms, sleep disturbances, and post-exertional symptom exacerbation. Paediatric dysautonomia is best conceptualised as a distributed brain-heart-vascular network disorder that requires mechanistic understanding, standardised orthostatic assessment, and careful exclusion of structural heart disease and arrhythmia. The rapid expansion of specialised dysautonomia programmes and direct-to-consumer diagnostic pathways has also contributed to broader, and occasionally premature, application of autonomic diagnoses. Management should follow a stepwise, mechanism-guided approach emphasising patient education, trigger avoidance, hydration and salt optimisation, lower-body compression, individualised exercise rehabilitation, pacing strategies when post-exertional symptom exacerbation is present, school accommodations, and phenotype-directed pharmacotherapy for persistent functional impairment. Although post-COVID dysautonomia shares features with established paediatric autonomic disorders, important gaps remain in disease definitions, mechanistic understanding, and evidence-based treatment, underscoring the need for multidisciplinary care, standardised diagnostic frameworks, and prospective paediatric research.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1329-1339"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-07-13DOI: 10.1017/S1047951126113705
Kimberly Morris, Hema Desai, Karli Negrin, Nancy Slater, Aparna Rao, Harjot Bassi, Christina Burford, Brittney Dixon, Kristin M Elgersma
{"title":"Feeding on flow: a survey of feeding practices for infants with CHD who require non-invasive ventilation.","authors":"Kimberly Morris, Hema Desai, Karli Negrin, Nancy Slater, Aparna Rao, Harjot Bassi, Christina Burford, Brittney Dixon, Kristin M Elgersma","doi":"10.1017/S1047951126113705","DOIUrl":"10.1017/S1047951126113705","url":null,"abstract":"<p><strong>Background: </strong>Infants with CHD experience feeding disruptions during a critical phase in oral feeding development. Dependency on high respiratory supports interfere with oral feeding opportunities. There is little evidence guiding oral feeding practices for infants requiring high flow nasal cannula and nasal continuous positive airway pressure. The aim of this study was to describe current US institutional feeding practices for infants with CHD on non-invasive ventilation.</p><p><strong>Methods: </strong>This was a cross-sectional survey of clinicians from primarily US institutions that were members of the Cardiac Neurodevelopmental Outcomes Collaborative.</p><p><strong>Results: </strong>From 35 institutions contacted, 20 (57%) feeding specialists responded. Most institutions (80%) did not utilise formal guidelines for oral feeding introduction on nasal continuous positive airway pressure or high flow nasal cannula. Most institutions (80%) did not allow full oral feeds on nasal continuous positive airway pressure, but 70% centres allowed full oral nutrition on high flow nasal cannula and (85%) allowed small volume oral feeding with specifications for the level of oxygen support. While most respondents (65%) reported feeding assessment completion on all infants both pre and postoperatively, few (30%) institutions utilised a formal cue-based assessment.</p><p><strong>Conclusion: </strong>Responses indicate that institutions generally do not allow oral feeding on respiratory support above high flow nasal cannula. Most centres do not utilise formal respiratory/cue based assessments to determine infant feeding readiness while on non-invasive ventilation. Future multidisciplinary research and quality improvement initiatives are needed to examine the effects of feeding infants with CHD while on non-invasive ventilation and to develop centre-specific guidelines to direct feeding progression, with potential to improve oral feeding outcomes while supporting multisystem stability.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1356-1360"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-07-09DOI: 10.1017/S1047951126113948
Kazu Ishikawa, Susumu Urata, Ki-Sung Kim
{"title":"An infant with junctional ectopic tachycardia treated with a multidrug regimen including ivabradine.","authors":"Kazu Ishikawa, Susumu Urata, Ki-Sung Kim","doi":"10.1017/S1047951126113948","DOIUrl":"10.1017/S1047951126113948","url":null,"abstract":"<p><p>An infant with junctional ectopic tachycardia developed tachycardia-induced cardiomyopathy requiring extracorporeal membrane oxygenation for circulatory failure. After oxygenation withdrawal became feasible following intravenous antiarrhythmics, tachycardia recurred with oral transition. Subsequent ivabradine administration resulted in heart rate control and improved cardiac function. We emphasise the role of ivabradine in heart rate control and cardiac function stabilisation in junctional ectopic tachycardia.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1501-1504"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-07-13DOI: 10.1017/S104795112611395X
Colin J McMahon, Karim Diab, Michael Kim, Giovanni Di Salvo, Jeffrey Phillip Jacobs
{"title":"Motivations, challenges, and sustainability of paediatric cardiology journal editors.","authors":"Colin J McMahon, Karim Diab, Michael Kim, Giovanni Di Salvo, Jeffrey Phillip Jacobs","doi":"10.1017/S104795112611395X","DOIUrl":"10.1017/S104795112611395X","url":null,"abstract":"<p><strong>Background: </strong>Journal editors play a central role in academic publishing. However, little is known about the experiences of editors within paediatric cardiology. This study aimed to explore the motivations, workload, peer review challenges, and sustainability of editorial roles in this specialty.</p><p><strong>Methods: </strong>A cross-sectional, anonymous survey was conducted among paediatric cardiology journal editors and associate editors. Quantitative responses were analysed descriptively, and free-text responses underwent inductive thematic analysis.</p><p><strong>Results: </strong>A total of 28 editors participated. Most respondents (82.1%) identified education and mentorship as key motivations for editorial work. However, 78.6% reported that editorial roles are becoming increasingly difficult, and only 21.4% reported having sufficient protected time, highlighting substantial workload pressures. Reviewer fatigue was a major challenge, with 75.0% reporting difficulty securing timely, high-quality peer review. While 57.9% acknowledged that impact factor influences editorial considerations, 89.5% agreed that journals with lower impact factors remain highly valuable for education. Only 28.6% of respondents considered the current editorial model sustainable, with 46.4% expressing concern regarding long-term sustainability.</p><p><strong>Conclusions: </strong>Paediatric cardiology journal editors demonstrate strong intrinsic motivation but face increasing workload, reviewer fatigue, and limited institutional support. These findings highlight a growing imbalance between editorial expectations and available support structures. Greater institutional recognition, provision of protected time, and pragmatic innovation in peer review processes may be required to sustain editorial engagement and maintain the educational and scientific mission of paediatric cardiology publishing.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1373-1379"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-06-30DOI: 10.1017/S1047951126113729
Alejandro Goldsman, Erica Victoria Stelmaszewski, Andres Gonzalez Ortiz, Milena Del Pilar Prada Casilimas, Oscar Arevalo Leal, Julio Biancolini, Angela Sardella, Olga Maza Caneva, Ricardo Pignatelli
{"title":"Dexrazoxane in children receiving anthracyclines: efficacy, safety, and region-specific considerations for Latin America.","authors":"Alejandro Goldsman, Erica Victoria Stelmaszewski, Andres Gonzalez Ortiz, Milena Del Pilar Prada Casilimas, Oscar Arevalo Leal, Julio Biancolini, Angela Sardella, Olga Maza Caneva, Ricardo Pignatelli","doi":"10.1017/S1047951126113729","DOIUrl":"10.1017/S1047951126113729","url":null,"abstract":"<p><strong>Background: </strong>Anthracyclines are indispensable in paediatric oncology but are associated with well-recognised dose-dependent cardiotoxicity that may result in progressive cardiomyopathy and late heart failure. Dexrazoxane has emerged as a potential primary cardioprotective strategy; however, concerns regarding safety, secondary malignancies, and possible interference with antitumour efficacy have historically limited its widespread adoption.</p><p><strong>Objectives: </strong>To critically review current evidence regarding the efficacy, safety, and clinical applicability of dexrazoxane in children receiving anthracycline-based chemotherapy, including region-specific implications for Latin America.</p><p><strong>Methods: </strong>Narrative review of randomised controlled trials, observational studies, systematic reviews, meta-analyses, and international guideline statements evaluating cardiac outcomes, survival, toxicity profiles, and second primary malignancy risk.</p><p><strong>Results: </strong>Dexrazoxane consistently demonstrates cardioprotective effects, including reduced biomarkers of myocardial injury and improved preservation of left ventricular systolic function, particularly among patients exposed to higher cumulative anthracycline doses. Available data indicate no significant adverse impact on relapse rates, event-free survival, or overall survival. Although early studies raised concerns about increased second primary malignancies, subsequent investigations have yielded inconsistent results, leaving residual uncertainty.</p><p><strong>Conclusions: </strong>Dexrazoxane represents an effective cardioprotective strategy in selected high-risk paediatric patients. A risk-adapted approach balancing cardioprotection, oncologic safety, and healthcare resources is warranted.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1340-1343"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiology in the YoungPub Date : 2026-07-01Epub Date: 2026-07-24DOI: 10.1017/S1047951126123464
Jihye You
{"title":"High-degree atrioventricular block in a child with an <i>ANK2</i> variant and long QT phenotype requiring leadless pacemaker implantation.","authors":"Jihye You","doi":"10.1017/S1047951126123464","DOIUrl":"10.1017/S1047951126123464","url":null,"abstract":"<p><p>Ankyrin-B syndrome, which has been linked to variants in <i>ANK2</i> and classified as long QT syndrome type 4, is characterised by heterogeneous arrhythmic manifestations, including sinus node dysfunction and conduction abnormalities. Clinically significant atrioventricular block requiring permanent pacing in paediatric patients has rarely been described. We report a 10-year-old boy who presented with recurrent syncope and seizure-like episodes. Electrocardiography demonstrated QT prolongation, and continuous monitoring revealed persistent high-degree atrioventricular block. Genetic testing identified a heterozygous <i>ANK2</i> variant of uncertain significance (NM_001148.4:c.5626G>A, p. Glu1876Lys), which was also detected in his mother and brother, while his father tested negative. Family evaluation revealed variable phenotypic expression, and a sister who died suddenly at 12 years of age had no available genotype but had autopsy findings of structural cardiac abnormalities. This case highlights clinically significant conduction disease in a child found to harbor an <i>ANK2</i> VUS and long-QT phenotype and underscores the importance of detailed family phenotyping, rhythm surveillance, and individualised management.</p>","PeriodicalId":9435,"journal":{"name":"Cardiology in the Young","volume":" ","pages":"1532-1535"},"PeriodicalIF":0.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}