Related Experiment Video
Updated: Aug 28, 2025
Measuring Cardiac Autonomic Nervous System ANS Activity in Toddlers - Resting and Developmental Challenges
Published on: February 25, 2016
Clinical Predictors of Recurrent Supraventricular Tachycardia in Infancy
Judson A Moore1, Sara B Stephens1, Naomi J Kertesz2
1Department of Pediatrics and the Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Houston, Texas, USA.
Insights
Infants diagnosed with supraventricular tachycardia (SVT) have a 33% recurrence rate. Key risk factors include Wolff-Parkinson-White syndrome and late diagnosis, while early diagnosis without WPW and first-line therapy indicate a lower risk.
Area of Science:
- Pediatric Cardiology
- Electrophysiology
- Neonatal Medicine
Background:
- Limited data exists on the recurrence risk of supraventricular tachycardia (SVT) in infants.
- Understanding recurrence patterns is crucial for effective infant SVT management.
Purpose of the Study:
- To determine the incidence of SVT recurrence in infants with structurally normal hearts.
- To identify factors associated with SVT recurrence in this population.
Main Methods:
- Retrospective and prospective phone follow-up study of 460 infants diagnosed with re-entrant SVT at age ≤1 year.
- Classification and regression tree analysis used to develop a risk algorithm for SVT recurrence.
- Median follow-up of 5.2 years, with primary outcome being the first SVT recurrence post-discharge.
Main Results:
- 33% of infants experienced SVT recurrence during the follow-up period.
- Significant recurrence risk factors identified: Wolff-Parkinson-White (WPW) syndrome, fetal or late diagnosis (>60 days), and need for multi-antiarrhythmic or second-line therapy.
- WPW syndrome presented the highest risk; among those without WPW, age at diagnosis was the primary predictor.
Conclusions:
- Infants with SVT are typically diagnosed early (≤60 days) and are predominantly male.
- Early diagnosis, absence of WPW, and first-line monotherapy (e.g., propranolol) are associated with the lowest SVT recurrence risk.
- Identifying risk factors like WPW and diagnosis timing allows for tailored management strategies to minimize recurrence.
Background:
Data regarding recurrence risk among infants with supraventricular tachycardia (SVT) are limited.
Objectives:
The purpose of this study was to determine incidence and factors associated with SVT recurrence.
Methods:
This was a retrospective single-center study (1984-2020) with prospective phone follow-up of infants with structurally normal hearts diagnosed at age ≤1 year with re-entrant SVT. Primary outcome was first SVT recurrence after hospital discharge. Classification and regression tree analysis was performed to determine a risk algorithm.
Results:
Among 460 infants (62% male), 87% were diagnosed at ≤60 days of age (median 13 days; IQR: 1-31 days). During a median follow-up of 5.2 years (IQR: 1.8-11.2 years), 33% had recurrence. On multivariable analysis, factors associated with recurrence included: fetal or late (>60 days) diagnosis (HR: 1.90; 95% CI: 1.26-2.86; and HR: 1.73; 95% CI: 1.07-2.77, respectively), Wolff-Parkinson-White (WPW) syndrome (HR: 2.46; 95% CI: 1.75-3.45), and need for multi-antiarrhythmic or second-line therapy (HR: 2.08; 95% CI: 1.45-2.99). Based on the classification and regression tree analysis, WPW incurred the highest risk. Among those without WPW, age at diagnosis was the most important factor predicting risk. Fetal or late diagnosis incurred higher risk, and if multi-antiarrhythmic or second-line therapy was also required, risk nearly doubled. Infants without WPW, who were diagnosed early (0-60 days), and who were discharged on propranolol were at lowest recurrence risk.
Conclusions:
Infants with SVT are most likely to be diagnosed at ≤60 days and be male. Risk factors for recurrence (occurred in 33%), present at time of diagnosis, include WPW, fetal or late diagnosis, and multi-antiarrhythmic or second-line therapy. Infants with early diagnosis, without WPW, and discharged on first-line monotherapy are at lowest recurrence risk.
Related Concept Videos
01:28Dysrhythmias II: Classification of Tachyarrhythmias
01:29Dysrhythmias III: Characteristics of Dysrhythmias
01:17Increased pulse rate
Many factors can elevate the risk of developing tachycardia. These include advanced age, a family history of arrhythmias, and an...
01:29Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
01:28Mechanism of Cardiac Arrhythmias
01:14Decreased pulse rate
There are specific risk factors that can elevate the likelihood of developing bradycardia. Advanced age is a significant factor, with...