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Multicenter Study
. 2023 Mar;182(3):1089-1097.
doi: 10.1007/s00431-022-04757-5. Epub 2022 Dec 28.

Multicenter cohort study on duration of antiarrhythmic medication for supraventricular tachycardia in infants

Minna Mecklin  1   2 , Anniina Linnanmäki  3 , Anita Hiippala  4 , Topias Leino  5 , Anita Arola  5 , Markku Leskinen  6 , Hanna Ruotsalainen  7 , Juha-Matti Happonen  4 , Tuija Poutanen  8   3
Affiliations
Multicenter Study

Multicenter cohort study on duration of antiarrhythmic medication for supraventricular tachycardia in infants

Minna Mecklin et al. Eur J Pediatr. 2023 Mar.

Abstract

Antiarrhythmic medication (AM) is commonly used to prevent supraventricular tachycardia (SVT) recurrence in infants. Our aim was to determine whether a shorter duration of AM is sufficient to prevent atrioventricular reentrant tachycardia (AVRT) recurrence and evaluate risk factors for recurrence of SVT after discontinued AM.This multicenter cohort study included all infants diagnosed with SVT in the five university hospitals in Finland between 2005 and 2017. Those diagnosed between 2005 and 2012 received AM for 12 months (group 1), and those diagnosed between 2013 and 2017 received AM for 6 months (group 2). A total of 278 infants presented with AVRT (group 1, n = 181; group 2, n = 97), and the median AM duration was 12.0 months (interquartile range [IQR] 11.4-13.4) and 7.0 months (IQR 6.0-10.2), respectively. Propranolol was the most frequently used first-line AM (92% and 95%). Recurrence-free survival rates were over 88% until 12 months after AM prophylaxis in both groups, without any statistically significant difference between them. Independent risk factors for recurrence of SVT after discontinuation of AM were need of combination AM (HR 2.2, 95% CI 1.14-4.20), Wolff-Parkinson-White (WPW) syndrome (HR 2.4, 95% CI 1.25-4.59), and age over 1 month at admission (HR 2.2, 95% CI 1.12-4.48). Conclusion: Shortening AM duration in infants from 12 to 6 months does not seem to lead to more frequent SVT recurrence. The risk factors for recurrence of SVT were WPW syndrome, need of combination AM, and age over 1 month.

Keywords: Antiarrhythmic medication; Atrioventricular reentrant tachycardia; Infants; Prophylaxis; Supraventricular tachycardia.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Recurrence-free survival after discontinuation of antiarrhythmic medication in the two groups of infants with supraventricular tachycardia in 2005–2012 and 2013–2017
Fig. 2
Fig. 2
Recurrence-free survival after discontinuation of antiarrhythmic medication in infants with reentrant supraventricular tachycardia (n = 278) separated for age groups, antenatal arrhythmia, combination antiarrhythmic medication, and Wolff-Parkinson-White syndrome (WPW)
See this image and copyright information in PMC

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