Clinical Predictors of Recurrent Supraventricular Tachycardia in Infancy.

Autor:	Moore JA; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Stephens SB; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Kertesz NJ; Department of Pediatrics and Section of Pediatric Cardiology, Nationwide Children's Hospital, Columbus, Ohio, USA., Evans DL; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Kim JJ; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Howard TS; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Pham TD; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Valdés SO; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., de la Uz CM; Department of Pediatrics, Division of Pediatric Cardiology, Johns Hopkins University, Baltimore, Maryland, USA., Raymond TT; Department of Pediatrics, Cardiac Critical Care, Medical City Children's Hospital, Dallas, Texas, USA., Morris SA; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA., Miyake CY; Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA; Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, Texas, USA. Electronic address: cymiyake@bcm.edu.
Jazyk:	angličtina
Zdroj:	Journal of the American College of Cardiology [J Am Coll Cardiol] 2022 Sep 20; Vol. 80 (12), pp. 1159-1172.
DOI:	10.1016/j.jacc.2022.06.038
Abstrakt:	Background: Data regarding recurrence risk among infants with supraventricular tachycardia (SVT) are limited. Objectives: The purpose of this study was to determine incidence and factors associated with SVT recurrence. Methods: This was a retrospective single-center study (1984-2020) with prospective phone follow-up of infants with structurally normal hearts diagnosed at age ≤1 year with re-entrant SVT. Primary outcome was first SVT recurrence after hospital discharge. Classification and regression tree analysis was performed to determine a risk algorithm. Results: Among 460 infants (62% male), 87% were diagnosed at ≤60 days of age (median 13 days; IQR: 1-31 days). During a median follow-up of 5.2 years (IQR: 1.8-11.2 years), 33% had recurrence. On multivariable analysis, factors associated with recurrence included: fetal or late (>60 days) diagnosis (HR: 1.90; 95% CI: 1.26-2.86; and HR: 1.73; 95% CI: 1.07-2.77, respectively), Wolff-Parkinson-White (WPW) syndrome (HR: 2.46; 95% CI: 1.75-3.45), and need for multi-antiarrhythmic or second-line therapy (HR: 2.08; 95% CI: 1.45-2.99). Based on the classification and regression tree analysis, WPW incurred the highest risk. Among those without WPW, age at diagnosis was the most important factor predicting risk. Fetal or late diagnosis incurred higher risk, and if multi-antiarrhythmic or second-line therapy was also required, risk nearly doubled. Infants without WPW, who were diagnosed early (0-60 days), and who were discharged on propranolol were at lowest recurrence risk. Conclusions: Infants with SVT are most likely to be diagnosed at ≤60 days and be male. Risk factors for recurrence (occurred in 33%), present at time of diagnosis, include WPW, fetal or late diagnosis, and multi-antiarrhythmic or second-line therapy. Infants with early diagnosis, without WPW, and discharged on first-line monotherapy are at lowest recurrence risk. Competing Interests: Funding Support and Author Disclosures Dr Miyake is supported by National Heart, Lung, and Blood Institute K23HL136932. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. (Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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