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

Abstract

Supraventricular tachycardia (SVT) is a common pediatric tachycardia, but the true incidence is unknown. We sought to investigate the true postnatal incidence and its medical needs. 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. 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%. 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.