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Preliminary assessment of paediatric electrophysiology cardiac implantable electronic device resources around the
M Cecilia Gonzalez Corcia1, Mitchell I Cohen2, Thomas Paul3
1Department of Paediatric Cardiology, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Insights
Global pediatric electrophysiology care faces significant inequities. The ARROW survey reveals disparities in expertise and resources for cardiac implantable electronic devices, particularly in low-income regions, impacting patient care.
Area of Science:
- Cardiology
- Pediatric Electrophysiology
- Global Health
Background:
- The Pediatric and Congenital Electrophysiology Society (PACES) focuses on care for children and adults with congenital heart disease (CHD) and arrhythmias.
- Global disparities exist in accessing advanced cardiac care.
Purpose of the Study:
- To assess global needs and inequities in cardiac implantable electronic devices (CIEDs).
- To identify resource gaps in pediatric electrophysiology worldwide.
Main Methods:
- The ARROW (Assessment of Rhythm Resources arOund the World) survey was distributed online to cardiology and electrophysiology specialists.
- The survey targeted physicians in Pediatric Cardiology, Cardiology, Electrophysiology, and Pediatric Electrophysiology.
Main Results:
- 42 responders from 28 countries participated, with 50% from low-/middle-income regions.
- Significant differences observed in pediatric electrophysiology expertise (50% vs. 93%) and invasive procedure capabilities (35% vs. 93%) between low-/middle- and high-income regions.
- Device implantation in low-income areas heavily relies on patient resources (71%), and follow-up care is less consistently managed by specialists compared to high-resource centers.
Conclusions:
- The ARROW survey provides an initial overview of geographical disparities in pediatric electrophysiology.
- Further research is needed to comprehensively map the state of pediatric electrophysiology globally.
- The findings underscore the need for international collaboration to improve arrhythmia services for children in developing regions, with data presented at the 2023 World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS).
Background:
The Pediatric and Congenital Electrophysiology Society (PACES) is a global organisation committed to the care of children and adults with CHD and arrhythmias.
Objective:
To evaluate the global needs and potential inequities as it relates to cardiac implantable electronic devices.
Methods:
ARROW (Assessment of Rhythm Resources arOund the World) is an online survey about cardiac implantable electronic devices, sent electronically to physicians within the field of Cardiology, Pediatric Cardiology, Electrophysiology and Pediatric Electrophysiology.
Results:
ARROW received 42 responders from 28 countries, 50% from low-/middle-income regions. The main differences between low-/middle- and high-income regions include availability of expertise on paediatric electrophysiology (50% versus 93%, p < 00.5) and possibility to perform invasive procedures (35% versus 93%, p < 0.005). Implant of devices in low-income areas relies significantly on patient's resources (71%). The follow-up of the devices is on the hands of paediatric cardiologist/electrophysiologist in higher resources centres (93% versus 50%, p < 0.05).
Conclusions:
The ARROW survey represents an initial assessment of the geographical characteristics in the field of Pediatric Electrophysiology. The next step is to make this "state of the art" more extensive to other aspects of the expertise. The relevance of collecting this data before the World Congress of Pediatric Cardiology and Cardiac Surgery (WCPCCS) in 2023 in Washington DC was emphasised in order to share the resulting information with the international community and set a plan of action to assist the development of arrhythmia services for children within developing regions of the world.
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