Is paroxysmal supraventricular tachycardia truly benign? Insightful association between PSVT and stroke from a National Inpatient Database Study

Abstract

Background

Atrial fibrillation and flutter are well-known causes of stroke. Whether other atrial arrhythmias categorized as paroxysmal supraventricular tachycardia (PSVT) are associated with stroke is less clear. We aimed to evaluate the association of PSVT with ischemic and embolic stroke and its impact on short-term outcomes in hospitalized stroke patients.

Methods

National Inpatient Sample database of the USA was used to assess the association of PSVT with ischemic stroke. Atrial fibrillation and flutter were excluded to minimize the confounding effects. The association of PSVT with stroke was evaluated using univariate and multivariate analysis. Subgroup analyses by gender, age, and stroke type were also performed.

Results

PSVT was associated with increased odds of overall ischemic stroke in univariate [OR 1.18 (95% CI 1.09–1.27) p < 0.001] analysis. No such association was observed in multivariate analysis (OR 1.06 (95% CI 0.98–1.14) p = 0.1) or with subgroup analysis by gender and age. However, PSVT was associated with embolic stroke in both univariate (OR 2.01 (95%CI 1.67–2.43, p < 0.001) and multivariate analysis (OR 1.7 (95%CI 1.4–2.14) p < 0.001) as well as in subgroup analyses by gender and age. Furthermore, the presence of PSVT was associated with increased mortality in embolic stroke (OR 4.11, CI 2.29 to 7.39, p < 0.001) and increased total hospital cost and length of hospital stay in all stroke types.

Conclusions

PSVT is independently associated with higher prevalence of embolic stroke but not with overall ischemic stroke. Patients with embolic stroke in the presence of PSVT have worse in-hospital outcomes with increased mortality.

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Abbreviations

PSVT:

Paroxysmal supraventricular tachycardia

AF:

Atrial fibrillation

AFl:

Atrial flutter

CI:

Confidence interval

OR:

Odds ratio

NIS:

National Inpatient Sample

ICD:

International Classification of Disease

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Correspondence to Dhanunjaya Lakkireddy.

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Supplementary Appendix: ICD-9 codes used for identification of study population (DOCX 12 kb)

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Sharma, S.P., Kondur, A., Gopinathannair, R. et al. Is paroxysmal supraventricular tachycardia truly benign? Insightful association between PSVT and stroke from a National Inpatient Database Study. J Interv Card Electrophysiol 59, 35–41 (2020). https://doi.org/10.1007/s10840-019-00651-7

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Keywords

  • Paroxysmal supraventricular tachycardia
  • Ischemic stroke
  • Embolic stroke
  • National Inpatient database