Pediatric/Adult Congenital Heart Disease -> Pediatric Cardiology D-PO06 - Poster Session VI (ID 26) Poster

D-PO06-061 - Do We Need Specific Exercise Recommendation Guidelines For Pediatric Hypertrophic Cardiomyopathy? (ID 1493)


Background: Lack of pediatric specific guidelines creates the potential for variation regarding exercise recommendations (ER) for pediatric hypertrophic cardiomyopathy (PHCM) patients.
Objective: To assess for practice variation in ER among PHCM providers
Methods: We surveyed the Pediatric and Adult Congenital Electrophysiology Society (PACES) and the Pediatric Heart Transplant Study (PHTS) group for provider demographics and ER in PHCM.
Results: Ninety-one providers responded. ER varied with 53% clearing for mild to moderate activity only, 18% restricting to low impact only and 17% giving no restrictions. History of caring for a patient who had a sports-related adverse event (47% of responders) is associated with ER (p = 0.03) and none of these individuals chose \"no restrictions\" for the patient in the vignette. ER is also associated with training background in pediatric electrophysiology (42% of responders, Group 1) or pediatric heart failure (40% of responders, Group 2). Direct comparison of Groups 1 and 2 shows significant differences in ER for the vignette (p = 0.002) and for patients with primary prevention ICD (p =0.01). Group 2 responders were more likely to recommend mild to moderate activity only or full restriction (Figure 1). Group 2 responders were younger (p<0.001) and more likely to work in a dedicated HCM clinic (p = 0.008). Type of training remains significant even when comparing duration of practice < 10 yrs or > 10 yrs (p = 0.04).
Conclusion: ER in PHCM are varied and differ significantly by provider background which suggests a need for multidisciplinary, standardized guidelines.