Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, 2301 Erwin Road, DUMC Box 3127, Durham, NC, 27710, USA.
Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO, USA.
Pediatr Cardiol. 2022 Dec;43(8):1857-1863. doi: 10.1007/s00246-022-02924-x. Epub 2022 May 10.
Supraventricular tachycardia (SVT) is a common pediatric arrhythmia. The objective of this investigation was to investigate the existence and degree of the health disparities in the treatment of pediatric patients with supraventricular tachycardia based on sociodemographic factors. This was retrospective cohort study at a large academic medical center including children ages 5-18 years old diagnosed with SVT. Patients with congenital heart disease and myocarditis were excluded. Initial treatment and ultimate treatment with either medical management or ablation were determined. The odds of having an ablation procedure were determined based on patient age, sex, race, ethnicity, and insurance status. There was a larger portion of non-White patients (p = 0.033) within the cohort that did not receive an ablation during the study period. Patients that were younger, female, American Indian/Alaskan Native, unknown race, and had missing insurance information were less likely to receive ablation therapy during the study period. In this single center, regional evaluation, we demonstrated that disparities in the treatment of pediatric SVT are present based on multiple patient sociodemographic factors. This study adds evidence to the presence of inequities in health care delivery across pediatric populations.
室上性心动过速（SVT）是一种常见的儿科心律失常。本研究旨在调查基于社会人口因素的儿科 SVT 患者治疗中是否存在健康差异及其程度。这是一项在大型学术医疗中心进行的回顾性队列研究，纳入年龄在 5-18 岁之间诊断为 SVT 的儿童患者。排除患有先天性心脏病和心肌炎的患者。根据患者的年龄、性别、种族、民族和保险状况，确定初始治疗和最终治疗是采用药物治疗还是消融术。在研究期间，未接受消融术的患者中非白人患者比例较大（p=0.033）。在研究期间，年龄较小、女性、美国印第安人/阿拉斯加原住民、未知种族和没有保险信息的患者接受消融治疗的可能性较小。在这项单中心、区域性评估中，我们证明了基于多个患者社会人口因素，儿科 SVT 治疗中存在差异。本研究为儿科人群的医疗保健提供方面存在的不平等现象提供了证据。
