Soham Dasgupta

Resuscitated cardiac arrest in a child triggers a comprehensive workup to identify an aetiology and direct management. The presence of a myocardial bridge does not automatically imply causation. Careful determination of the haemodynamic significance of the myocardial bridge is critical to avoid an unnecessary sternotomy and to provide appropriate treatment.

Combination Therapy of Ivabradine with Procainamide for the Management of Pediatric Postoperative Junctional Ectopic Tachycardia

Catheter ablation of the slow pathway to the atrioventricular node is generally a safe and effective treatment for atrioventricular nodal re-entry tachycardia (AVNRT). However, congenital anomalies of the inferior vena cava and superior draining veins can limit traditional catheter approaches to the right heart from femoral venous access and distort local anatomy within the triangle of Koch, necessitating alternative electrophysiology (EP) mapping and ablation strategies. Despite the widespread availability of non-fluoroscopic 3-dimensional imaging systems, many providers still rely on venography to describe unusual cardiovascular anatomy and fluoroscopy to position EP catheters when mapping and ablating the slow pathway. Herein, we report our experience with a pediatric patient with inducible AVNRT and atypical venous anatomy in whom slow pathway ablation was performed successfully without the use of fluoroscopy. In addition, we describe the modification of a novel mapping technique for targeting the slow pathway for ablation.

Introduction: Burnout among physicians may impact productivity and result in suboptimal patient care. Studies looking at burnout in a specific pediatric subspecialty are extremely limited. In a previous study, the authors evaluated the work–life balance and burnout among pediatric cardiology attending at our institution. This demonstrated early signs of reduced work engagement and possible burnout in the near future. To address this, the authors implemented a number of targeted interventions and conducted a follow-up survey to assess the effects of such changes. The objective of this study was to evaluate the current status of work–life balance and burnout among pediatric cardiologists at the author's institution compared to the general population and to the prior survey. Materials and Methods: Pediatric cardiology attending physicians were surveyed at the author's institution to assess their perception of burnout and work–life balance using the Maslach burnout inventory and the areas of work–life survey. Results: Forty-seven of the 52 pediatric cardiologists responded to the survey. They were divided into groups by their respective subspecialty: interventional/electrophysiology (n = 2), cardiac intensive care unit/inpatient (n = 9), noninvasive imaging (n = 6), outpatient (n = 22), and other (n = 8). When compared to the previous survey, the Maslach burnout inventory scores were significantly lower in the area of emotional exhaustion. However, most scores in the areas of work–life survey were lower than the prior survey. Conclusion: This follow-up study focusing on pediatric cardiology attending physicians demonstrated worsening burnout and signs of reduced work engagement compared to the previous survey 4 years ago. Interventions did not include bolstering our physician support systems and developing resiliency training for our physicians, which is an area the authors are going to focus on going forward. The following core competencies are addressed in this article: Medical knowledge, Practice-based learning, Systems-based practice.