EDITORIALPediatric & Congenital Electrophysiology Society: building an international paediatric electrophysiology organisation
Introduction
Paediatric electrophysiology is a unique discipline within paediatric cardiology, bridging a traditional outpatient clinic and inpatient and intensive care consulting role with an interventional procedure-based model. Paediatric electrophysiologists care for children and adults with CHD who have arrhythmias using a combination of pharmacological and non-pharmalogical therapies, including implantable devices and catheter ablation. In addition, with the expanding role of genomics in cardiovascular medicine, paediatric electrophysiologists have become the “go-to” experts in channelopathies such as long QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia. Sudden death in the young has received increasing attention in both medical and lay media and paediatric electrophysiologists have the expertise to guide the field, including screening programs, advocacy, and risk stratification for sudden death in children with CHD and cardiomyopathies. In this respect, paediatric electrophysiologists are often the central core of a multi-disciplinary team. Most large children’s hospitals in North America have 2 or more paediatric electrophysiologists; however, on an international level, most other countries rarely have more than 1 paediatric electrophysiologist – who may function additionally in an interventional or general role – per centre, whereas in some cases there may only be 1 paediatric electrophysiologist in a entire country, caring for a large number of children spread across vast regions. Other countries do not have any providers specifically trained in paediatric electrophysiology, but one or more adult electrophysiologists who work together with paediatric cardiologists to provide care.
As the world has become smaller with web-based communication, it has become progressively easier for paediatric electrophysiologists to communicate across previously challenging barriers. Individually, many Paediatric and Congenital Electrophysiology Society (PACES) members have reached out internationally to establish collegial professional relationships with practitioners in other countries, based on formal and informal visits and exchanges; however, effective implementation of a global paediatric electrophysiology community also requires an organising body that oversees and facilitates this activity – a body which nearly all paediatric electrophysiologists view as their “home.” To address this need, PACES recognised its responsibility in opening a dialogue beyond its traditional North American framework into a broadly expansive international role. It is possible that such an undertaking may be considered worthwhile by other paediatric cardiology subspecialty medical societies.
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PACES as an organisation
Founded by clinician leaders, PACES is a non-profit organisation comprised of individuals dedicated to improving the care of children and young adults with cardiac rhythm disturbances; one of the society’s high-quality collaboration and research and exchange of ideas on arrhythmia topics that are relevant to the interests of children and young adults with CHD. PACES is the “community of practice” to the Heart Rhythm Society with expertise in congenital and paediatric electrophysiology.
International paediatric electrophysiology meetings
Although PACES began in the 1980s with only a very small group of paediatric electrophysiologists, it now claims over 400 members worldwide. Although the small size of the society presents certain challenges, it also provides tremendous opportunities for innovation and growth, and one such opportunity is the expansion of our international presence, both in numbers of members and in the development of a shared global vision. On May 12, 2015, the predominantly North American leadership of PACES
Expanding PACES global vision: opportunities
After extensive discussions by all participants around many of the areas listed above, it became quite apparent that a more inclusive global paediatric electrophysiology vision was initially going to require four changes within the current PACES model.
Conclusions
The mission of PACES is to promote collaboration and research amongst those caring for children and young adults with arrhythmic conditions. Global implementation of this mission will be challenging. In 2015, PACES leadership, which historically has been predominantly North American, met with over 30 international paediatric electrophysiology representatives from over 17 countries to discuss both opportunities and challenges that exist in formalising international collaboration. Discussed among
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Cited by (1)
The Current State and Future Potential of Pediatric and Congenital Electrophysiology
2017, JACC: Clinical ElectrophysiologyCitation Excerpt :Although nearly one-third of PACES members practice outside North America, the Society operates primarily in North America. Currently, the PACES leadership is making a concerted effort to transform the society into a more global organization (1). Alongside these efforts, there is the potential for pediatric electrophysiologists to improve their global influence on the clinical care of pediatric and congenital patients with heart rhythm disorders (89).