Postnatal cumulative incidence of supraventricular tachycardia in a general pediatric population: A national birth cohort database study

Abstract

Background: Supraventricular tachycardia (SVT) is a common pediatric tachycardia, but the true incidence is unknown.

Objective: We sought to investigate the true postnatal incidence and its medical needs.

Methods: We derived a birth cohort comprised children born between 2000 and 2008 who had complete postnatal medical data in the Taiwan National Health Insurance Database for the period from 2000 to 2014.

Results: From 1,967,911 live births, we identified 2021 patients with SVT (51.6% men), accounting for an overall incidence of 1.03 per 1000 patient-years (Wolff-Parkinson-White syndrome accounted for 16.2%). The cumulative incidence was 0.06, 0.25, 0.45, 0.88, and 1.39 per 1000 patient-years by the age of 1 month, 1 year, 5 years, 10 years, and 15 years, respectively. Major congenital heart disease (5.3%; hazard ratio 6.66; 95% confidence interval 2.98-14.87) and cardiomyopathy (0.9%; hazard ratio 8.78; 95% confidence interval 3.39-22.78) were associated with mortality. In patients without major congenital heart disease, the cumulative incidence of SVT was 0.05, 0.22, 0.41, 0.84, and 1.33 per 1000 patient-years by the age of 1 month, 1 year, 5 years, 10 years, and 15 years, respectively. By the age of 15 years, the annual risk of death and sudden death was 0.13% and 0.01% per patient-year, respectively. Radiofrequency catheter ablation was performed in 173 patients at the median age of 11 years: 1.7% during infancy, 5.8% by the age of 5 years, and 31.8% by the age of 10 years. The probability of being free from receiving ablation by the age of 15 years was 83.4%.

Conclusion: This birth cohort study provides the true incidence of pediatric SVT and indicates that almost one-fifth of the patients with SVT have already received ablation in the pediatric ages.

Keywords: Birth cohort; Cumulative incidence; Incidence; Radiofrequency catheter ablation; Supraventricular tachycardia; Wolff-Parkinson-White syndrome.