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Safety and Feasibility of Exercise Rehabilitation in Children with Ventricular Assist Devices

Danielle S Burstein1, Michael G McBride2, Jonathan B Edelson2

  • 1Division of Cardiology, Children's Hospital of Philadelphia, 34th Street & Civic Center Boulevard, 8NW64, Philadelphia, PA, 19104, USA. bursteind@chop.edu.

Pediatric Cardiology
|February 9, 2022
PubMed

Insights

Pediatric patients with ventricular assist devices (VAD) can safely undergo exercise rehabilitation (ER) with high compliance. This study found no adverse events, suggesting ER may improve outcomes for children awaiting heart transplants.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Rehabilitation Medicine

Background:

  • Advanced heart failure in children often necessitates ventricular assist devices (VAD) as a bridge to heart transplantation.
  • Limited data exist on the safety and feasibility of exercise rehabilitation (ER) for pediatric VAD recipients.

Purpose of the Study:

  • To evaluate the safety and feasibility of exercise rehabilitation (ER) in children supported by VAD awaiting heart transplantation.

Main Methods:

  • Retrospective review of pediatric patients (1998-2019) who underwent VAD implantation and subsequently participated in ER.
  • ER sessions included aerobic and musculoskeletal conditioning, three times weekly, initiated post-ambulatory status after VAD implantation.
  • Data collected on patient demographics, VAD type, duration, cardiac diagnosis, and ER session completion rates and adverse events.

Main Results:

  • 29 pediatric patients (mean age 14.3 years) with cardiomyopathy or congenital heart disease were included.
  • 864 out of 1016 (85%) ER sessions were completed without adverse events like hypotension, arrhythmias, or VAD malfunction.
  • ER sessions commenced a median of 49 days post-VAD implantation with high patient compliance.

Conclusions:

  • Exercise rehabilitation (ER) is safe and feasible for pediatric patients with VAD support.
  • Early implementation of ER in this population demonstrates high compliance and no adverse events.
  • ER may serve as a crucial pre-transplant intervention to enhance functional capacity and potentially improve post-transplant outcomes in pediatric VAD recipients.

Keywords:
ChildrenExercise testingRehabilitationVentricular assist device

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