Case Fatality in Children with Supraventricular Tachycardia in the United States

Background: The prognosis for most patients with supraventricular tachycardia (SVT) is thought to be excellent. However, the fatality rate in children with SVT is poorly defined and there are no large-scale, multicenter studies to support this commonly held belief.

Methods: We reviewed an administrative database containing inpatient records from 41 stand-alone children's hospitals and identified all hospitalized patients younger than 25 years with a discharge diagnosis of SVT between January 2003 and September 2008.

Results: We analyzed the index hospitalization of 1,755 patients with the discharge diagnosis of SVT, of whom 58% were male and 52% had comorbid structural heart disease (SHD). There were a total of 68 patient deaths (4%) with 56 of 68 (82%) of the deaths occurring in patients with SHD. In total, 6% of the patients with SHD died, whereas only 1% of the patients without SHD died. Regression analysis revealed that case fatality is increased in patients less than 1 month of age (OR 2.41, 95% CI 1.35 to 4.32), in patients with SHD (OR 2.67, 95% CI 1.22 to 5.80), and in those having cardiomyopathy with (OR 6.72, 95% CI 1.79 to 25.28) and without SHD (OR 6.74, 95% CI 1.67 to 27.26).

Conclusions: The case fatality in patients who have SVT without SHD is low. It is increased in the very young and in those with comorbid cardiovascular disease. Case fatality is highest in patients with a cardiomyopathy regardless of SHD.