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The Incidence and Factors Associated with the Recurrence of Supraventricular Tachycardia in Children: 15 Years Experience from Middle-Income Country

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Abstract

Limited data are available concerning supraventricular tachycardia (SVT) recurrence. Hence, this study aimed to determine the incidence, outcome, and factors associated with SVT recurrence. This retrospective, observational, population-based study was conducted among children with SVT from 2006 to 2020. The primary outcome measure was SVT recurrence. Kaplan Meier analysis was used to estimate SVT-free at 1, 5, and 10 years after diagnosis. Cox regression analysis was used to identify independent factors associated with recurrence. There were 156 patients with SVT with a median age at diagnosis of 1.9 years (Interquartile range [IQR] 11 days to 8.7 years) and follow-up for a median of 3.5 years (IQR 1.7 to 6.1 years). 35 patients (22%) had recurrent SVT at a median age of 7.8 years (IQR 4.4 to 12 years). Infants with Wolff-Parkinson-White Syndrome (WPW) had the highest recurrence (11/16, 68%), with 33% SVT-free at 5 years follow-up. The lowest recurrence rate was observed in neonatal diagnosis (2/54, 3.7%) with 98% SVT-free at 5 years follow-up. The independent factors associated with the recurrence of SVT were the diagnosis of WPW with an adjusted hazard ratio (aHR) of 5.2 (95% CI 2.4–11.2), age of more than 1 year at diagnosis (aHR 3.7 95% CI 1.4–9.7), and combine with or need second-line therapy (aHR 4.0 95% CI 1.5–10.7). One in five children with SVT experienced a recurrence, which is more likely for those with WPW, multiple maintenance therapy, and older age at first presentation. Whereas neonates with non-WPW may benefit from shorter maintenance therapy.

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Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the Director-General of Health Malaysia for permission to publish this article.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Hospital Sultanah Aminah, Ministry of Health Malaysia, Persiaran Abu Bakar Sultan, 80100, Johor Bahru, Johor DT, Malaysia

    Mohd Nizam Mat Bah, Baljit Kaur Boparam & Mohd Hanafi Sapian

  2. Department of Pediatrics, Faculty of Medicine, University of Malaya, Lembah Pantai, Kuala Lumpur, Malaysia

    Norazah Zahari

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Contributions

All authors contributed to the study conception and design. BKP, MHS, NZ, and MNMB performed material preparation, data collection, and analysis. MNMB wrote the first draft of the manuscript, and all authors commented on previous versions. Finally, all authors read and approved the final manuscript.

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Correspondence to Mohd Nizam Mat Bah.

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All procedures performed in studies involving human participants followed the clinical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Medical Research and Ethics Committee, Ministry of Health, Malaysia [ID No: NMRR-22-00048-LM0 (IIR)].

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Informed consent was waived from all individual participants in the study due to the nature of the study by the Medical Research and Ethics Committee.

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Bah, M.N.M., Zahari, N., Boparam, B.K. et al. The Incidence and Factors Associated with the Recurrence of Supraventricular Tachycardia in Children: 15 Years Experience from Middle-Income Country. Pediatr Cardiol 45, 292–299 (2024). https://doi.org/10.1007/s00246-023-03374-9

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