Pediatric patients with cardiomyopathy undergoing cardiac catheterization had a low rate of major adverse events (MAE) when compared to the general pediatric population, according to a recent study published in JAHA.

Including 4,932 procedures (median age 10 years, 53.4% dilated cardiomyopathy) captured by the ACC's IMPACT Registry between April 2016 and December 2024, Khalifah A. Aldawsari, MD; Kevin F. Kennedy, MS; and Alejandro Martinez Herrada, MD, explored the incidence of MAE in pediatric patients with cardiomyopathy undergoing cardiac catheterization. They also compared the rate of MAE across different types of cardiomyopathy.

The overall rate of MAE was 3.17%, with the most common MAE being arrhythmia (42.3% of all MAE). Several patient- and procedure-related factors were associated with greater risk of MAE, including age less than 1 year, hypertrophic cardiomyopathy compared with dilated cardiomyopathy, preprocedural inotropic support, left femoral venous access, and systemic heparinization. Elective procedures, on the other hand, were less likely to result in MAE.

MAE rate varied by cardiomyopathy type. "No MAEs were observed in the arrhythmogenic right ventricular group, whereas [tachycardia-induced cardiomyopathy] had the highest event rate; however, this difference did not reach statistical significance," note the authors.

Aldawsari and colleagues address that the overall MAE rate they found was lower than previous reports, stating: "The improved MAE rate could be explained by different definitions used for the outcome variable in the studies, differences in selection criteria, and advancements in clinical practice over the nearly two decades between studies."

They also acknowledge several study limitations, including its retrospective design, missing details about diagnosis and overlap between cardiomyopathy phenotypes, and instances of incomplete data entry.