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Can adult heart failure regimens be applied to children: what works and what does not?
Current Opinion in Cardiology, 06/22/2012
Simpson KE et al. – Therapies for adults cannot be assumed to be generally applicable to all pediatric heart failure patients, especially in patients with systemic right ventricles or single ventricle physiology. Contrary to adult heart failure regimens, evidence supports treatment of symptomatic, but not asymptomatic, heart failure with angiotensin–converting enzyme inhibitors and beta–blockers in certain pediatric patients. Implantable cardioverter defibrillators continue to be used sparingly in children compared with adults due to low risk of sudden cardiac death. Finally, cardiac resynchronization therapy may be beneficial in children with symptomatic heart failure and moderate to severe dysfunction, although applying adult criteria to children remains a challenge.