These guidelines have been produced to bring together current recommendations on the evaluation and management of pediatric heart failure (HF) and update the previous guideline.
The writing group was chosen from the membership of the International Society for Heart and Lung Transplantation (ISHLT), the Association of European Pediatric and Congenital Cardiology (AEPC), and the Pediatric and Congenital Electrophysiology Society (PACES) across health care disciplines to achieve representation of HF practice throughout the world. Overall, 90 contributors from 13 counties across 4 continents (Appendix 1) were assigned various aspects of HF according to their expertise. A comprehensive review of the available published evidence for HF management was undertaken. The strength and level of evidence was assessed according to standard practice.2 The recommendations were achieved by consensus with the contributors; however, it is recognized that the evidence base for many of the recommendations is Level C due to the lack of trials in children. In some areas, there is such a lack of information that no recommendations can be made: it is hoped that by recognizing these deficiencies, research will be stimulated to address them. External review was undertaken by 8 international experts invited from adult advanced HF, pediatric cardiology, and congenital cardiovascular surgery (Appendix 2). The final guidelines were reviewed and approved by the ISHLT Board and Standards & Guidelines Committee, endorsed by the AEPC, and those guidelines pertinent to electrophysiology, by the PACES Executive Committee.