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Ambulatory Cardiac Monitoring in Infants with Supraventricular Tachycardia

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Abstract

Supraventricular tachycardia (SVT) is a frequent cause of tachyarrhythmia in infants < 1 year of age and ambulatory cardiac monitoring is an important tool for diagnosis and follow-up of these patients. We retrospectively reviewed 594 infants (mean age 4.05 months, SD 3.55; 54% M) who underwent ambulatory cardiac monitoring (69% 24 h Holter, 31% extended monitor) through the Pocket ECG system (MediLynx) between January 2016 and July 2020. 170 patients who had the ICD-10 code I47.1 for SVT used at enrollment were analyzed separately. 49 (8.3%) patients had sustained SVT or non-sustained SVT (nSVT) during the study period, including 20 patients (11.8%) who had the ICD-10 code I47.1 at enrollment. Extended ambulatory cardiac monitors detected 61% of all patients with nSVT or SVT and was superior when compared to 24 h Holter (p < 0.0001). In the overall group, the first episode of SVT or nSVT was detected within 24 h of monitoring in 40/49 patients (82%). 48/49 patients (98%) were diagnosed within a week of monitoring and the single remaining patient was diagnosed with nSVT at day 15 of monitoring. There was no significant difference in minimal, maximal, and average heart rate between patients with and without ICD-10 code I47.1 at enrollment or between patients with and without SVT or nSVT. Despite their low yield, ambulatory cardiac monitors are an important diagnostic tool. The ideal length of monitoring in patients with known or suspected SVT has yet to be defined, although all patients in our cohort were identified by day 15 of monitoring.

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Funding

The authors of this investigation and manuscript did not receive any funding or research support by any organization. Participants did not receive any financial support to participate in this study.

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Authors and Affiliations

  1. Albert Einstein College of Medicine/Children’s Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY, 10467, USA

    Nicolas M. Hidalgo Corral & Bradley C. Clark

  2. MEDICALgorithmics US Holding Corporation, Warsaw, Mazowieckie, Poland

    Olga Witkowska, Magdalena Ślusarczyk & Marek Dziubiński

Authors
  1. Nicolas M. Hidalgo Corral
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  2. Olga Witkowska
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  3. Magdalena Ślusarczyk
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  4. Marek Dziubiński
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  5. Bradley C. Clark
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Contributions

The authors have met appropriate authorship criteria and there have been no author omissions. The authors have approved the manuscript as submitted and had complete access to all study data.

Corresponding author

Correspondence to Nicolas M. Hidalgo Corral.

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Conflict of interest

Olga Witkowska: Employee of Medicalgorithmics S.A.—Medical and Technical Writer (Employee). Marek Dziubiński: Chairman of the Supervisory Board, equity interest in Medicalgorithmics S.A. (Ownership or partnership). Magdalena Ślusarczyk: Employee of Medicalgorithmics S.A. Clinical Consulting Director (Employee). Nicolas M. Hidalgo Corral and Bradley C. Clark have no financial or non-financial relationships to disclose.

Ethical Approval

The Institutional Review Board at the Albert Einstein College of Medicine approved this retrospective observational study. Only de-identified data were collected and analyzed. IRB #: 2020–12175 Reference #: 067818.

Informed Consent

Informed consent was not obtained as this study does not meet the definition of human subjects’ research, as the investigators are not interacting or intervening with living individuals or their identifiable information.

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We respectfully submit our manuscript, “Ambulatory Cardiac Monitoring in Infants with Supraventricular Tachycardia” for publication in Pediatric Cardiology. This manuscript has not been previously published and is not currently under consideration from other publications.

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246_2022_2925_MOESM1_ESM.eps

Supplementary file1 (EPS 996 kb) Supplementary Fig. 1 Example diagnostic strips from monitored patients. A. Beginning strip of a patient with supraventricular tachycardia. B. Strip of a patient with non-sustained supraventricular tachycardia. C. Strip of a patient with non-sustained ventricular tachycardia

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Hidalgo Corral, N.M., Witkowska, O., Ślusarczyk, M. et al. Ambulatory Cardiac Monitoring in Infants with Supraventricular Tachycardia. Pediatr Cardiol 43, 1864–1869 (2022). https://doi.org/10.1007/s00246-022-02925-w

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  • DOI: https://doi.org/10.1007/s00246-022-02925-w

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