Abstract
We sought to assess the effect of a shorter medication treatment course (up to 4–6 months of age) on the recurrence of infantile supraventricular tachycardia (SVT). This was a retrospective review of infants with SVT diagnosed at age 0–12 months at Rady Children’s Hospital (2010–2017). Infants with structural congenital heart disease, automatic tachycardias, atrial flutter, or lack of follow-up data were excluded. Seventy-four infants met criteria. Median age at diagnosis was 6 days (IQR 0–21 days); 28.4% presented with fetal tachycardia. Median gestational age was 38.4 weeks (IQR 36–40), 30% were preterm. Median age at medication discontinuation was 6.7 months (IQR 4.6–9.8). Therapy was stopped at younger age in patients managed by pediatric electrophysiologist (vs. general pediatric cardiologist): 4.9 vs. 8.6 months (p = 0.03). Thirty-eight patients (51.4%) were treated for < 6 months; 32.4% for 6–12 months, and 16.2% for > 12 months. SVT recurrence was similar for these groups: 13.2% vs. 16.7%, and 33.3%, respectively, (p = 0.27). Most patients with recurrence required emergency care, though none had significant adverse outcomes. Infants with SVT and structurally normal cardiac anatomy, who remain recurrence free on a single agent, have no increased risk of recurrence with shorter treatment courses of 4–6 months, compared to traditional treatment duration of 6–12 months.
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Abbreviations
- AVRT:
-
Atrioventricular reentrant tachycardia
- AVNRT:
-
AV nodal reentrant tachycardia
- CHD:
-
Congenital heart disease
- IQR:
-
Interquartile range
- SVT:
-
Supraventricular tachycardia
- WPW:
-
Wolff–Parkinson–White Syndrome
References
Garson A Jr, Gillette PC, McNamara DG (1981) Supraventricular tachycardia in children: clinical features, response to treatment, and long-term follow-up in 217 patients. J Pediatr 98(6):875–882
Sanatani S, Hamilton RM, Gross GJ (2002) Predictors of refractory tachycardia in infants with supraventricular tachycardia. Pediatr Cardiol 23(5):508–512
Perry JC, Garson A Jr (1990) Supraventricular tachycardia due to Wolff–Parkinson–White syndrome in children: early disappearance and late recurrence. J Am Coll Cardiol 16(5):1215–1220
Sanatani S, Potts JE, Reed JH et al (2012) The study of antiarrhythmic medications in infancy (SAMIS): a multicenter, randomized controlled trial comparing the efficacy and safety of digoxin versus propranolol for prophylaxis of supraventricular tachycardia in infants. Circ Arrhythm Electrophysiol 5(5):984–991
Till JA, Shinebourne EA (1991) Supraventricular tachycardia: diagnosis and current acute management. Arch Dis Child 66(5):647–652
Benson DW Jr, Dunnigan A, Benditt DG (1987) Follow-up evaluation of infant paroxysmal atrial tachycardia: transesophageal study. Circulation 75(3):542–549
Perry JC (2012) Supraventricular tachycardia treatment efficacy in infants: on further review. Circ Arrhythm Electrophysiol 5(5):882–883
Guerrier K, Shamszad P, Czosek RJ, Spar DS, Knilans TK, Anderson JB (2016) Variation in antiarrhythmic management of infants hospitalized with supraventricular tachycardia: a multi-institutional analysis. Pediatr Cardiol 37(5):946–952
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Aljohani, O.A., Herrick, N.L., Borquez, A.A. et al. Antiarrhythmic Treatment Duration and Tachycardia Recurrence in Infants with Supraventricular Tachycardia. Pediatr Cardiol 42, 716–720 (2021). https://doi.org/10.1007/s00246-020-02534-5
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DOI: https://doi.org/10.1007/s00246-020-02534-5