B-PO05-189 IMPACT OF SOCIODEMOGRAPHIC FACTORS ON PEDIATRIC PATIENTS UNDERGOING ELECTROPHYSIOLOGY STUDY

Abstract

Sociodemographic factors impact outcomes in congenital heart disease, but data in pediatric patients with arrhythmia disorders is lacking. To determine the impact of sociodemographic factors on the evaluation, health care utilization, treatment, and outcomes in pediatric patients with SVT and/or ventricular pre-excitation (WPW) referred for EP study (EPS). A retrospective chart review collected clinical and sociodemographic data in patients ≤ 18 yrs with SVT and/or WPW who underwent EPS between 2019 to 2020. Outcome measures included age at diagnosis, cardiac evaluation, and EPS; use of diagnostic testing; emergency room (ER) visits; treatment with medication and ablation; and procedure success. Among the 69 patients (49% female), diagnoses included WPW syndrome (32%), Isolated pre-excitation (16%), AVNRT (22%), ORT (13%), EAT (10%), and non-inducible (7%). Insurance included public (26%), private (45%), and HMO (29%). HMO patients trended younger at initial evaluation, 9.6 yrs (IQR: 2 - 13.5) vs public [13.3 yrs (IQR: 2.2 - 15.7)] and private [14.3 yrs (IQR: 9.6-16.2)]; p=0.051. Race included White (48%), Asian (9%), Black or African American (4%), Native Pacific Islander (3%), other (23%), or unknown/declined (13%). Non-Whites had a lower success rate for ablation (86% vs 100%; p=0.046). Ethnicity included Hispanic/Latino (26%), Not Hispanic/Latino (67%), and unknown/declined (7%). Hispanic/Latino patients were younger at initial evaluation [6.6 yrs (IQR: 0 - 13.2) vs 12.9 yrs (IQR: 9.0 - 15.6); p=0.04] but had a longer time between arrhythmia diagnosis and EPS [548 days (IQR: 162 - 1577) vs 148 days (IQR: 91 - 263); p=0.03]. Single-parent households had increased use of cryoablation (36% vs. 10%, p<0.01). Gender, language, median income, and distance to EP lab were not associated with outcome measures. No differences in the use of monitoring, ER, or medication were seen based on all sociodemographic factors. Non-White race, Hispanic/Latino ethnicity, insurance type, and household structure impacted the evaluation and treatment of pediatric patients with SVT and/or WPW referred for EPS. Further investigation is needed to address health disparities in pediatric patients with arrhythmia disorders.