PMID- 37610637 OWN - NLM STAT- MEDLINE DCOM- 20230926 LR - 20230926 IS - 1432-1971 (Electronic) IS - 0172-0643 (Linking) VI - 44 IP - 8 DP - 2023 Dec TI - Characterizing the Use of Exercise Testing in Repaired Tetralogy of Fallot Patients: A Multi-Institutional Survey. PG - 1821-1830 LID - 10.1007/s00246-023-03269-9 [doi] AB - Cardiopulmonary exercise testing (CPET) is an important tool used in the management of patients with congenital heart disease. However, there are no clear guidelines for its use in specific populations, such as repaired Tetralogy of Fallot (rTOF). We sought to characterize current practice patterns and attitudes regarding exercise testing in the rTOF population using an online survey distributed to pediatric cardiologists. Analyses were performed using qualitative statistics, Wilcoxon rank-sum, Kruskal-Wallis test, and chi-squared analysis. 103 clinicians completed the survey with 83% routinely sending symptomatic rTOF patients for exercise testing and 59% for asymptomatic patients. Respondents who routinely test asymptomatic patients reported higher levels of perceived helpfulness of exercise testing (p < 0.01) and comfort with CPET interpretation (p < 0.01). Although a large majority of respondents found exercise testing to be helpful (81% either "somewhat" or "very" helpful"), a considerably smaller portion indicated comfort with CPET interpretation (49% either "comfortable" or "very comfortable"). Nearly all respondents (92%) reported changing management primarily based on exercise testing results. However, the frequency of changes varied, with 10% "frequently", 62% "occasionally", 19% "rarely" changing management. There was a statistically significant relationship between the perceived helpfulness of exercise testing and the likelihood of management changes (p < 0.01). While exercise testing is used to make clinical decisions, our findings suggest that in some cases, management changes may be made without a similar degree of confidence in interpreting CPET findings. The variability in attitudes and practices highlights the need for evidence-based guidelines addressing exercise testing in rTOF, particularly for asymptomatic patients. CI - (c) 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Drastal, Meghan AU - Drastal M AUID- ORCID: 0000-0003-1301-1393 AD - Columbia University Vagelos College of Physicians and Surgeons, New York, NY, 10032, USA. meghansdrastal@gmail.com. FAU - Layton, Aimee M AU - Layton AM AUID- ORCID: 0000-0002-5452-2811 AD - Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork Presbyterian Morgan Stanley Children's Hospital, New York, NY, 10032, USA. FAU - Fremed, Michael A AU - Fremed MA AUID- ORCID: 0000-0001-8672-6782 AD - Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork Presbyterian Morgan Stanley Children's Hospital, New York, NY, 10032, USA. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230823 PL - United States TA - Pediatr Cardiol JT - Pediatric cardiology JID - 8003849 SB - IM UOF - Res Sq. 2023 Jul 07;:. PMID: 37461658 MH - Child MH - Humans MH - *Exercise Test/methods MH - *Tetralogy of Fallot/surgery/epidemiology MH - Ventricular Function, Right OTO - NOTNLM OT - Aerobic capacity OT - Cardiology OT - Cardiopulmonary exercise test OT - Pediatric OT - Survey OT - Tetralogy of fallot EDAT- 2023/08/23 12:43 MHDA- 2023/09/26 13:44 CRDT- 2023/08/23 11:13 PHST- 2023/07/01 00:00 [received] PHST- 2023/08/07 00:00 [accepted] PHST- 2023/09/26 13:44 [medline] PHST- 2023/08/23 12:43 [pubmed] PHST- 2023/08/23 11:13 [entrez] AID - 10.1007/s00246-023-03269-9 [pii] AID - 10.1007/s00246-023-03269-9 [doi] PST - ppublish SO - Pediatr Cardiol. 2023 Dec;44(8):1821-1830. doi: 10.1007/s00246-023-03269-9. Epub 2023 Aug 23.