Evaluation of clinical features and prognosis in children with supraventricular tachycardia

Abstract

Introduction: This study aims to investigate the clinical characteristics of pediatric patients diagnosed with supraventricular tachycardia (SVT) and assess their shortterm prognosis. Materials and Methods: Data from 213 patients diagnosed with SVT between 2010 and 2015 at the Department of Pediatric Cardiology, Bursa Uludag University Faculty of Medicine, were retrospectively reviewed. Results: The ratio of male to female patients was 1: 1.25. Regarding treatment response and prognosis, the recurrence rate of SVT attacks was higher in males. The most common complaint at the time of diagnosis was palpitation. Furthermore, 17.8% of patients were diagnosed due to tachycardia detected during routine check-ups; almost all were under one year of age. In 56.3% of patients, the initial diagnosis was made at the pediatric emergency clinic. In acute treatment, 30% of patients were treated with vagal maneuvers; 61% had their attacks terminated, while 41% received drug therapy. Adenosine was the most used drug, and it successfully terminated attacks in 79% of patients receiving it. In the evaluation of patients' follow-ups after the initial attack, 56.3% of patients experienced recurrences, and 71% of second attacks occurred within the first three months. Prophylactic drug therapy was initiated in 94.4% of patients, with an average duration of 2.5 +/- 1.6 years. After treatment discontinuation, 75.4% of patients remained symptom-free, while 24.6% experienced SVT attacks again. Electrophysiological studies were performed in 16.9% of patients at another centers, and ablation was applied to 15.5%. Conclusion: Patients with SVT may be asymptomatic during infancy and vagal stimulation and adenosine response was quite good in acute treatment. Prophylactic medical treatment was effective in children whose weight is <15 kg and the recurrences were low after discontinuation especially in infants.