Contemporary Burden and Correlates of Symptomatic Paroxysmal Supraventricular Tachycardia

Abstract

BackgroundContemporary data about symptomatic paroxysmal supraventricular tachycardia (PSVT) epidemiology are limited. We characterized prevalence and correlates of symptomatic PSVT within a large healthcare delivery system and estimated national PSVT burden.Methods and ResultsWe identified adults with an encounter for potential PSVT between 2010 and 2015 in Kaiser Permanente Northern California, excluding those with prior known atrial fibrillation or atrial flutter. We adjudicated medical records, ECGs, and other monitoring data to estimate positive predictive values for targeted International Classification of Diseases (ICD), 9th and 10th Revisions codes in inpatient, emergency department, and outpatient settings. Combinations of diagnosis codes and settings were used to calculate PSVT prevalence, and PSVT correlates were identified using multivariable regression. We estimated national rates by applying prevalence estimates in Kaiser Permanente to 2010 US Census data. The highest positive predictive values included codes for “PSVT” in the emergency department (82%), “unspecified cardiac dysrhythmia” in the emergency department (27%), “anomalous atrioventricular excitation” as a primary inpatient diagnosis (33%), and “unspecified paroxysmal tachycardia” as a primary inpatient diagnosis (23%). Prevalence of symptomatic PSVT was 140 per 100 000 (95% confidence interval, 100–179) and was higher for individuals who were older, women, white or black, or who had valvular heart disease, heart failure, diabetes mellitus, lung disease, or prior bleeding. We estimate the national prevalence of symptomatic PSVT to be 168 per 100 000 (95% confidence interval, 120–215).ConclusionsSelected diagnostic codes in inpatient and emergency department settings may be useful to identify symptomatic PSVT episodes. We project that at least 0.168% of US adults experience symptomatic PSVT, and certain characteristics can identify people at higher risk.

Prevalence and incidence of patients with paroxysmal supraventricular tachycardia in the United States

“…7 These specific ICD-9 and ICD-10 codes were chosen as they have previously been shown to most accurately document a true diagnosis of PSVT. 5 More than one diagnosis was required in the outpatient setting to improve specificity, as diagnoses coded in the emergency department or inpatient settings tend to more reliably code for true arrhythmia episodes.…”

Continuous Blood Pressure Estimation From Electrocardiogram and Photoplethysmogram During Arrhythmias

“…Arrhythmias is an age-related disease (Hatch et al, 2011;Khurshid et al, 2018). For instance, the incidence of paroxysmal supraventricular arrhythmias is 14.8 per 100,000 person-years in adults aged 18 to 24 years, but in persons aged ≥65 years, the rate is increased to 231.9 per 100,000 person-years (Go et al, 2018). It is estimated that by 2050, supraventricular-related arrhythmias will affect approximately nine million individuals aged >60 years in China (Tse et al, 2013).…”

Update on Etripamil Nasal Spray for the At-home Treatment of Acute Paroxysmal Supraventricular Tachycardia

“…The recent PRE-EMPT study retrospectively evaluated health records of over 4.2 million people in the USA, estimating PSVT incidence at 73/100,000, and national prevalence at 168/100,000 (translating into some 393,810 affected American adults), with older and female individuals being more at risk. 1 On the other side of the Atlantic, the UK Biobank prospective population cohort study, looking at the records of 502,627 people aged 40-69, showed a baseline prevalence of PSVT at 0.28%, overall prevalence of 0.42%, and an incidence of 0.51 cases per 1,000 person-years. 2 The National Hospital Ambulatory Medical Care Survey estimated that in the USA, 50,000 emergency department visits per year were attributed to PSVT, at a cost upward of US$190 million.…”