There is little standardization across pediatric heart failure centers when it comes to the use of exercise testing and cardiac rehabilitation (CR) after VAD placement. “Variation in Cardiac Rehabilitation for Pediatric Ventricular Assist Device Recipients Across North America” describes existing practice variations and identifies barriers to exercise testing and CR. This ACTION article, published in ASAIO Journal on February 12, 2021, provides descriptive statistics gleaned from a survey representing 52 respondents from 28 VAD centers across the US.
Here’s what you need to know about the survey:
- 38% reported performing exercise testing.
- 65% used 6-minute walk tests rather than formal cycle or treadmill exercise testing.
- All respondents refer to physical therapy during the initial inpatient stay for VAD placement, but only 52% refer to a CR program.
- CR was performed at an ACTION center (84%), a local specialized center (21%), or a home-based CR program (26%).
- Over 90% of centers were interested in implementing a standardized pediatric VAD CR program.
Additionally, common barriers to exercise testing and CR include inadequate resources/implementation logistics knowledge, concerns about safety, inability of patients to travel to a CR facility, and concern about utility of exercise testing or CR. The good news is that most of the pediatric VAD centers surveyed were interested in implementing a standardized CR program for recipients despite the perceived barriers. ACTION plans to implement a CR protocol to all ACTION centers to improve pre-transplant waitlist rehabilitation and post-transplant outcomes.
Congratulations to the ACTION leaders from pediatric VAD centers across the nation who co-authored this article: Danielle Burstein of Children’s Hospital of Philadelphia, Angela Lorts of Cincinnati Children’s Hospital Medical Center, David Rosenthal of Lucile Packard Children’s Hospital, David Peng of C.S. Mott Children’s Hospital, Jodie Lantz of Children’s Health Dallas / UT Southwestern, Hari Tunuguntla of Texas Children’s Hospital, and Samuel Wittekind of Cincinnati Children’s Hospital Medical Center
Burstein, Danielle S.*; McBride, Michael*; Lorts, Angela†; Rosenthal, David‡; Peng, David M.§; Lantz, Jodie¶; Tunuguntla, Hari‖; Zinn, Matthew#; Curran, Tracy**; Wittekind, Samuel† Variation in Cardiac Rehabilitation for Pediatric Ventricular Assist Device Recipients Across North America, ASAIO Journal: February 12, 2021 – Volume Online First – Issue – doi: 10.1097/MAT.0000000000001335