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Supraventricular Tachycardia Without Preexcitation as a Cause of Sudden Cardiac Arrest in Pediatric Patients

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Abstract

Sudden cardiac arrest in pediatric patients is a rare occurrence. Supraventricular tachycardia without the presence of ventricular preexcitation in pediatric patients with a structurally normal heart is generally considered benign. Previous literature in adults reported a subset of patients in whom SVT was suspected to be the primary trigger of sudden cardiac arrest. We performed a single-center, retrospective cohort study of pediatric patients without known heart disease, 1–21 years of age, presenting with aborted SCA between 2009 and 2019. We collected diagnostic studies in all patients to identify the etiology of the aborted SCA. Thirty patients met the inclusion criteria. The median age at the time of SCA was 15.2 years. The etiology of SCA was identified in 23 (77%) patients. Of the seven patients with unknown diagnosis after initial diagnostic studies, three patients subsequently developed fast SVT that was presumed to be the etiology of the initial SCA. These three patients had varying diagnoses of atrioventricular nodal reentry tachycardia, ectopic atrial tachycardia, and a concealed accessory pathway with atrioventricular reentrant tachycardia. After ablation or medical treatment of the SVT substrate, no further tachyarrhythmias were observed. Pediatric patients presenting with an aborted SCA of unknown etiology ought to be considered for electrophysiology testing to elicit occult SVT substrates that may lead to a malignant ventricular tachyarrhythmia.

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The data collected will not be deposited in a shared data repository.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, Columbia University Irving Medical Center, 3959 Broadway CHN 2-255, New York, NY, 10032, USA

    Nak Hyun Choi, Eric S. Silver & Leonardo Liberman

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  1. Nak Hyun Choi
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  2. Eric S. Silver
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  3. Leonardo Liberman
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Contributions

Drs. C, S, and L contributed to the study conception and design. Material preparation, data collection and analysis were performed by Drs. C, S, and L. The first draft of the manuscript was written by Dr. C and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Leonardo Liberman.

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The authors have no relevant conflicts of interest to disclose.

Ethical Approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Institutional Review Board of Columbia University Medical Center approved this study.

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Waiver of informed consent was granted by the Institutional Review Board of Columbia University Medical Center in the setting of retrospective study. Research involving materials (data, documents, and records) were collected previously for nonresearch purposes.

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Choi, N.H., Silver, E.S. & Liberman, L. Supraventricular Tachycardia Without Preexcitation as a Cause of Sudden Cardiac Arrest in Pediatric Patients. Pediatr Cardiol 43, 218–224 (2022). https://doi.org/10.1007/s00246-021-02720-z

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  • DOI: https://doi.org/10.1007/s00246-021-02720-z

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