Allied Professionals (Non-physician submissions only) -> Clinical Research D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-039 - Stress Testing In Pediatric Patients With Cardiac Devices Is Safe And Promotes Rate Response Optimization (ID 1194)

 J. Posey: Nothing relevant to disclose.


Background: Exercise testing in pediatric pacemaker patients: Safe, helpful, and underused
Objective: Assess the safety and utility of exercise testing in pediatric patients with IPGs
Methods: Retrospective chart review of all IPG patients aged 6-20 yrs presenting for device clinic follow up between 1/2018-10/2019 was performed. Patients with a problem-focused visit, cognitive and/or physical limitations or deemed high risk for EST were excluded.
Results: Two hundred one patients were included and 93 had an EST (Gp A) while 108 did not (Gp B). There were no significant differences between Gp A and Gp B based on age (p=.09), presence of structural heart disease (p=0.4) or EP Diagnosis (CCHB (p=.6), SHB (p=.9), and SSS diagnosis (p=.6). IPG programming changes were made in 50% of Gp A pts, compared to 43% of Gp B pts. Of the changes in Gp A pts, 40% were related to the EST and included changes in rate response, timing, and medical management (ie medication change or Holter placement) (Figure 1). “Other” included changes to outputs or sensing and were unrelated to EST. Gp A patients more frequently had changes made to their rate response function than Gp B (p=0.006). Among GpA pts who had a maximal EST, 53% had a low VO2max, 64% an abnormal max HR and 14% had a low O2 pulse. No adverse events occurred.
Conclusion: EST is safe and frequently led to IPG programming changes. Abnormal EST results were common suggesting a high prevalence of activity limitation in this population. Repeat EST will be required to see if the programming changes improved EST results.