Publications
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Burst Exercise Testing Can Unmask Arrhythmias in Patients With Incompletely Penetrant Catecholaminergic Polymorphic Ventricular Tachycardia (2021)
- Catecholaminergic polymorphic ventricular tachycardia (CPVT) is characterized by cardiac arrest during sudden exertion. Standard exercise stress testing (EST) involves gradual exertion, leading to misdiagnosis and undertreatment of CPVT. “Burst” EST represents a safe modification that better mimics a typical CPVT triggering event to improve diagnosis and therapeutic decision making in CPVT.
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Post Traumatic Stress as a determinant of quality of life in pediatric solid organ transplant recipients (2021)
- This restrospective, cross-sectional review indicated a high prevalence of self-reported post traumatic stress symptoms in children who survive with solid organ transplants, which are significantly associated with self-rated quality of life. There is a need for clinicians to improve mental health screening and intervention programs.
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Potential Role of Life Stress in Unexplained Sudden Cardiac Arrest (2021)
- This exploratory study aimed to determine whether patients who experienced an unexplained sudden cardiac arrest (USCA) had higher stressful life events prior to their cardiac arrest compared to those with an explained sudden cardiac arrest (ESCA) and healthy controls. Although there was no difference in stressful life events between the SCA groups and controls, those with an USCA had higher stressful life events compared to the ESCA group. The autonomic nervous system likely mediates the interaction between stress and SCA.
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Intermediate-coupled premature ventricular complexes and ventricular tachycardia during exercise recovery (2021)
- This paper presented 3 unrelated and unprecedented cases of adolescent male patients with structurally normal hearts that had ventricular tachycardia (VT) in the recovery period following exercise stress testing. Patients with intermediate-coupled premature ventricular complexes (PVCs) have an increased frequency of PVCs with exercise that initiate VT in the recovery period. This electrocardiogram entity may represent a variant of short-coupled variant torsades de pointes in pediatric patients.
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Potential overdiagnosis of congenital long QT syndrome in children and adolescents evaluated with exercise stress testing (2020)
- Long QT syndrome is a dangerous arrhythmia disorder. This retrospective and observational study suggest that the selected children and adolescents at low risk of LQTS may have unexplained dynamic QT interval prolongation. The diagnostic utility of the QT stand test and the exercise stress test remains unclear.
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Children with congenital heart disease exhibit seasonal variation in physical activity (2020)
- This prospective cohort study demonstrated that physical activity level changes across seasons in children with congenital heart disease and the importance of being aware of these fluctuations when interpreting physical activity levels. Season specific counselling for physical activity may be beneficial in the clinical setting.
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Physical activity is associated with better vascular function in children and adolescents with congenital heart disease (2020)
- In this cross-sectional cohort study, higher levels of physical activity are associated with better vascular function in children and adolescents with congenital heart disease. Thus, promoting physical activity should be a high priority in the care for this population.
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Physical Activity and its correlates in a pediatric solid-organ transplant population (2020)
- The results of this retrospective cross-sectional review suggest that older age at time of completing the physical activity survey and presence of sensory disability may influence physical activity levels in the young solid organ transplant population.
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Adolescents with solid organ transport: Using the BRIEF2 parent-report and self-report to measure parent-child agreement and everyday executive function (2020)
- There are higher rates of executive dysfunction in adolescents with solid organ transplant than their peers. Adolescents and their parents completed a behaviour rating scale using the Behaviour Rating Inventory of Executive Function, Second Edition (BRIEF2).
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Utility of 3D printed cardiac models in congenital heart disease: a scoping review (2020)
- This review targets published literature on the use of 3D printed congenital heart disease models (3D-CMs), which are experiential reports instead of scientific studies. There is insufficient evidence to determine the benefit of 3D-CMs over other health technologies.
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Reduced physical activity during COVID-19 pandemic in children with congenital heart disease (2020)
- Children with congenital heart disease have significantly reduced physical activity compared with before the COVID-19 pandemic, measured by Fitbit step counts. There are undetermined short and long term health impacts of this behaviour change, which are dependent on the duration of public health measures.
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Utility and access to 3D printing in the context of congenital heart disease: An international physician survey study (2020)
- This cross-sectional survey of pediatric cardiologists agree that 3D printing is a technology that benefits the care of children with congenital heart disease (CHD). In pediatric cardiology, 3D models are primarily used for procedural planning for CHD lesions.
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Somatic Symptom Disorder and the Physician’s Role (2020)
- This letter is addressed to the editor of an article about somatic symptom disorder and the physician’s role in perpetuating the disorder. Dysautonomia of adolescence (DAOA) can limit daily living and is associated with mental health issues, and patients often see multiple specialists for a diagnosis.
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Evaluation of conventional troponin I testing for the detection of myocardial dysfunction in children (2020)
- Troponin is a marker of myocardial injury. This retrospective chart review determined that troponin testing identified few cases of myocardial dysfunction with only 66% sensitivity, and thus has limited utility as a screen for myocardial injury in children.
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Fontan-associated liver disease: Spectrum of disease in children and adolescents (2020)
- This study found that liver disease was present in the cohort of pediatric patients with Fontan Physiology. Transient elastography is a potential prospective marker of liver disease.
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Pubertal hormonal changes and the autonomic nervous system: potential role in paediatric orthostatic intolerance (2019)
- The peak incidence of cardiovascular autonomic dysfunction in young women occurs at approximately 10-15 years old, a time where many hormones involved in puberty are capable of predisposing to disorders of orthostatic intolerance. This study reviews these pubertal hormones and their potential role in autonomic dysfunction.
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From ‘it makes me feel free’ to ‘they won’t let me play’: The body and physical activity-related perceptions and experiences of children with congenital heart disease and their parents (2020)
- This study utilized narrative inquiry to conduct semi-structured interviews of children with congenital heart disease and their parents. This study examines the complexities of the activity participation of children with congenital heart disease and can help with inclusive physical activity programming to optimize health and wellbeing of children.
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Physiological responses to exercise in pediatric heart transplant recipients (2019)
- Pediatric heart transplant (HTx) recipients have typically two thirds of predicted values of exercise capacity. This study showed that HTx had similar metabolic responses to controls despite having smaller LV chambers and an attenuated increase in hemodynamic responses. This could be due to increasing peripheral oxygen extraction.
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Pulmonary artery wall thickness in children with Fontan physiology: An optical coherence tomography case control study (2019)
- Optical coherence tomography evaluted the structural changes within the pulmonary arteries of Fontan patients compared to those with normal pulmonary circulation. This study found that pulmonary artery wall dimensions are normal in Fontan children.
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Echocardiographic Assessment of Ventricular Function During Exercise in Adolescent Female Patients with Anorexia Nervosa (2019)
- Adolescent patients with anorexia nervosa have reduced exercise capacity and peak cardiovascular indices compared with control subjects but normal patterns of cardiovascular response and systolic ventricular function during exercise.
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Optical Coherence Tomography for the Early Detection of Coronary Vascular Changes in Children and Adolescents After Cardiac Transplantation: Findings From the International Pediatric OCT Registry. (2018)
- Heart transplant patients undergo routine heart catheterization surveillance including angiography and optical coherence tomography (OCT). This study found that OCT provided information that angiography did not. So, OCT is a useful indicator of vessel health that is not detected by other means.
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Predictors of electrocardiographic screening failure for the subcutaneous implantable cardioverter-defibrillator in children: A prospective multicenter study (2018)
- Patients with a device inserted under their skin to make sure their heart does not stop – an ICD – had a 12-lead ECG test and a PMS test to help researchers better understand what factors can predict who, out of the people that might benefit from an ICD, is a good candidate.
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Modifiable cardiovascular risk factors in adolescents and adults with congenital heart disease. (2018)
- Youth and adult patients with congenital heart disease were surveyed about their health behaviours related to cardiovascular risk. A small portion of patients with CHD are in ideal cardiovascular health. Therefore, promoting healthy behaviours throughout youth and adulthood in this population is important.
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Intimal thickening at coronary bifurcations in pediatric heart transplant recipients. (2017)
- In heart transplant recipients, optical coherence tomography (OCT) was performed and vessel health was assessed at vessel junctions. This study found changes primarily in the left vessel system and that they were linked to the size of the vessels joining together.
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Safety and effectiveness of Flecainide in Children in the Current Era (2017)
- A review of past research about the use of the drug flecainide in children with regular hearts or congenital heart disease for treating irregular heart rhythms to assess its safety and effectiveness. This study found that Flecainide was well tolerated and that arrhythmia control did not differ between congenital heart disease patients and those with healthy hearts.
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Validity of Commercial Activity Trackers in Children With Congenital Heart Disease (2017)
- This study evaluated the step counting function of the wrist-worn Fitbit Charge HR alongside a hip-worn research grade accelerometer, worn at the same time for one week during participants’ normal activities. Boys and girls ages 10-18 with congenital heart disease participated.
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Physical Activity Tracker Study & Physical Activity Tracker – Provincial Scale-Up Study (2017)
- This study investigated the effect of customized physical activity programme, monitored by a Fitbit wearable tracker, on physical activity levels, exercise tolerance and heart health in children and teens with congenital heart disease. This study was done in a local cohort. Boys and girls ages 10-18 years with congenital heart disease participated.
