Development of the Pediatric Exercise Data Analytics and Learning (PEDAL) Network: a novel registry dedicated to exercise testing in congenital and paediatric acquired heart disease

BACKGROUND: Exercise testing is an established tool for assessing cardiorespiratory function, guiding management, and predicting outcomes in children, adolescents, and adults with congenital and/or paediatric acquired heart disease. Despite its widespread use, substantial variability exists among clinical paediatric exercise laboratories in testing protocols, calibration techniques, data interpretation, and reporting, limiting multicentre collaboration and data comparability. OBJECTIVE: To describe the formation of a registry focused on pediatric exercise testing. METHODS: The Pediatric Exercise Data Analytics and Learning Network was established in 2023 by six institutions as the first multicentre paediatric-focused exercise testing registry in the United States dedicated to patients with heart disease. The Pediatric Exercise Data Analytics and Learning Network has two primary actions: 1) develop and maintain a multicentre registry with uniform data definitions to support quality improvement and research; and 2) establish a learning network to advance education and knowledge sharing through standard operating procedures, benchmarking dashboards, and collaborative initiatives. Integration with Cardiac Networks United links the Pediatric Exercise Data Analytics and Learning Network's functional exercise testing data with existing longitudinal heart disease registries, creating opportunities for high-impact quality improvement and research. To foster objectives, the Pediatric Exercise Data Analytics and Learning Network aims to build a diverse network of both individual and hospital members who will work collaboratively to improve the consistency and value of paediatric and congenital exercise testing, advance quality improvement and research, and enhance long-term outcomes for patients with heart disease. CONCLUSION: This document describes the formation of PEDAL including organizational structure, database creation, and future directions.