Is hospitalization necessary for treatment of SVT? Predictive variables for recurrence and negative outcome.

In this article we attempt to identify variables that may predict which pediatric patients presenting with supraventricular tachycardia to the emergency department are at risk for immediate recurrence or negative outcome. We studied an 11-year chart review and follow-up of pediatric patients presenting to the pediatric ED with a diagnosis of SVT. Recurrences of SVT during the first 24 hours after initial episode and occurrences of negative outcome (ie, respiratory distress, cardiac arrest) during hospital stay were measured. 51 patients met our inclusion criteria: 74.5% were treated as inpatients. 18% experienced a recurrence during 24 hours; 3 patients were less than 3 months of age. Recurrence within 90 minutes of conversion occurred in 4/7 patients. All negative outcomes (3.9%) occurred in the less than 3-month age group. Patients less than 3 months or with immediate supraventricular tachycardia recurrence may have a higher probability of recurrence and negative outcome and therefore may require hospitalization.