Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias

Tommaso Bucci; Luigi Gerra; Steven H. M. Lam; Antonios A. Argyris; Giuseppe Boriani; Riccardo Proietti; Arnaud Bisson; Laurent Fauchier; Gregory Y. H. Lip

doi:10.1016/j.hrthm.2024.11.044

Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias

Tommaso Bucci
, Luigi Gerra
, Steven H. M. Lam
, Antonios A. Argyris
, Giuseppe Boriani
, Riccardo Proietti
, Arnaud Bisson
, Laurent Fauchier
, Gregory Y. H. Lip^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › Research › peer-review

2 Citations (Scopus)

3 Downloads (Pure)

Abstract

Background
Few data are available on the clinical course of patients with supraventricular tachycardia (SVT).

Objective
The purpose of this study was to assess the 1-year risk of adverse events in patients with SVT.

Methods
This was a retrospective observational study conducted within TriNetX. On the basis of the International Classification of Diseases, Tenth Revision, Clinical Modification codes recorded at the emergency department admission, patients not taking oral anticoagulation were categorized into SVT, atrial fibrillation (AF), atrial flutter, or control (CTRL) groups. The primary outcome was the 1-year risk of a composite of all-cause death or thromboembolism. Cox regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after 1:1 propensity score matching. Sensitivity analyses were performed in clinically relevant subgroups. Incident AF and new oral anticoagulation prescriptions were reported during the study period.

Results
We identified 23,524 patients with SVT (mean age 54.6±19.3 years; 14,000 [59.5%] women), 5413 with atrial flutter (66.9±15.7 years; 1907 [35.2%] women), 157,715 with AF (72.5±14.0 years, 68,813 [43.6%] women), and 150,807 CTRLs (43.0±17.4 years; 88,540 [58.7%] women). After propensity score matching, the risk of composite outcome in patients with SVT was higher than that in CTRLs (HR 2.89; 95% CI 2.65–3.17) but lower than that in patients with atrial flutter (HR 0.87; 95% CI 0.79–0.97) and those with AF (HR 0.69; 95% CI 0.65–0.73). The risk of adverse events in patients with SVT was more pronounced during the first 30 days in males, those aged ≥65 years, or those with multimorbidity. Patients with SVT had an increased risk of incident AF than did CTRLs.

Conclusion
The increased risk of adverse events in patients with SVT appears to be most pronounced in the short term and partly associated with the increased likelihood of incident AF.

Original language	English
Journal	Heart Rhythm
Volume	22
Issue number	6
Pages (from-to)	1504-1511
Number of pages	8
ISSN	1547-5271
DOIs	https://doi.org/10.1016/j.hrthm.2024.11.044
Publication status	Published - 1 Jun 2025

Bibliographical note

Keywords

All-cause death
Atrial fibrillation
Atrial flutter
Supraventricular tachycardia
Thromboembolism

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10.1016/j.hrthm.2024.11.044Licence: CC BY 4.0

Bucci et al. (2025) Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardiasFinal published version, 880 KBLicence: CC BY 4.0

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@article{1278df581cf941c38c2872fea3172b2a,

title = "Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias",

abstract = "Background Few data are available on the clinical course of patients with supraventricular tachycardia (SVT). Objective The purpose of this study was to assess the 1-year risk of adverse events in patients with SVT. Methods This was a retrospective observational study conducted within TriNetX. On the basis of the International Classification of Diseases, Tenth Revision, Clinical Modification codes recorded at the emergency department admission, patients not taking oral anticoagulation were categorized into SVT, atrial fibrillation (AF), atrial flutter, or control (CTRL) groups. The primary outcome was the 1-year risk of a composite of all-cause death or thromboembolism. Cox regression analysis was used to calculate hazard ratios (HRs) and 95\% confidence intervals (CIs) after 1:1 propensity score matching. Sensitivity analyses were performed in clinically relevant subgroups. Incident AF and new oral anticoagulation prescriptions were reported during the study period. Results We identified 23,524 patients with SVT (mean age 54.6±19.3 years; 14,000 [59.5\%] women), 5413 with atrial flutter (66.9±15.7 years; 1907 [35.2\%] women), 157,715 with AF (72.5±14.0 years, 68,813 [43.6\%] women), and 150,807 CTRLs (43.0±17.4 years; 88,540 [58.7\%] women). After propensity score matching, the risk of composite outcome in patients with SVT was higher than that in CTRLs (HR 2.89; 95\% CI 2.65–3.17) but lower than that in patients with atrial flutter (HR 0.87; 95\% CI 0.79–0.97) and those with AF (HR 0.69; 95\% CI 0.65–0.73). The risk of adverse events in patients with SVT was more pronounced during the first 30 days in males, those aged ≥65 years, or those with multimorbidity. Patients with SVT had an increased risk of incident AF than did CTRLs. Conclusion The increased risk of adverse events in patients with SVT appears to be most pronounced in the short term and partly associated with the increased likelihood of incident AF.",

keywords = "All-cause death, Atrial fibrillation, Atrial flutter, Supraventricular tachycardia, Thromboembolism",

author = "Tommaso Bucci and Luigi Gerra and Lam, \{Steven H. M.\} and Argyris, \{Antonios A.\} and Giuseppe Boriani and Riccardo Proietti and Arnaud Bisson and Laurent Fauchier and Lip, \{Gregory Y. H.\}",

year = "2025",

month = jun,

day = "1",

doi = "10.1016/j.hrthm.2024.11.044",

language = "English",

volume = "22",

pages = "1504--1511",

journal = "Heart Rhythm",

issn = "1547-5271",

publisher = "Elsevier",

number = "6",

}

TY - JOUR

T1 - Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias

AU - Bucci, Tommaso

AU - Gerra, Luigi

AU - Lam, Steven H. M.

AU - Argyris, Antonios A.

AU - Boriani, Giuseppe

AU - Proietti, Riccardo

AU - Bisson, Arnaud

AU - Fauchier, Laurent

AU - Lip, Gregory Y. H.

PY - 2025/6/1

Y1 - 2025/6/1

N2 - Background Few data are available on the clinical course of patients with supraventricular tachycardia (SVT). Objective The purpose of this study was to assess the 1-year risk of adverse events in patients with SVT. Methods This was a retrospective observational study conducted within TriNetX. On the basis of the International Classification of Diseases, Tenth Revision, Clinical Modification codes recorded at the emergency department admission, patients not taking oral anticoagulation were categorized into SVT, atrial fibrillation (AF), atrial flutter, or control (CTRL) groups. The primary outcome was the 1-year risk of a composite of all-cause death or thromboembolism. Cox regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after 1:1 propensity score matching. Sensitivity analyses were performed in clinically relevant subgroups. Incident AF and new oral anticoagulation prescriptions were reported during the study period. Results We identified 23,524 patients with SVT (mean age 54.6±19.3 years; 14,000 [59.5%] women), 5413 with atrial flutter (66.9±15.7 years; 1907 [35.2%] women), 157,715 with AF (72.5±14.0 years, 68,813 [43.6%] women), and 150,807 CTRLs (43.0±17.4 years; 88,540 [58.7%] women). After propensity score matching, the risk of composite outcome in patients with SVT was higher than that in CTRLs (HR 2.89; 95% CI 2.65–3.17) but lower than that in patients with atrial flutter (HR 0.87; 95% CI 0.79–0.97) and those with AF (HR 0.69; 95% CI 0.65–0.73). The risk of adverse events in patients with SVT was more pronounced during the first 30 days in males, those aged ≥65 years, or those with multimorbidity. Patients with SVT had an increased risk of incident AF than did CTRLs. Conclusion The increased risk of adverse events in patients with SVT appears to be most pronounced in the short term and partly associated with the increased likelihood of incident AF.

AB - Background Few data are available on the clinical course of patients with supraventricular tachycardia (SVT). Objective The purpose of this study was to assess the 1-year risk of adverse events in patients with SVT. Methods This was a retrospective observational study conducted within TriNetX. On the basis of the International Classification of Diseases, Tenth Revision, Clinical Modification codes recorded at the emergency department admission, patients not taking oral anticoagulation were categorized into SVT, atrial fibrillation (AF), atrial flutter, or control (CTRL) groups. The primary outcome was the 1-year risk of a composite of all-cause death or thromboembolism. Cox regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) after 1:1 propensity score matching. Sensitivity analyses were performed in clinically relevant subgroups. Incident AF and new oral anticoagulation prescriptions were reported during the study period. Results We identified 23,524 patients with SVT (mean age 54.6±19.3 years; 14,000 [59.5%] women), 5413 with atrial flutter (66.9±15.7 years; 1907 [35.2%] women), 157,715 with AF (72.5±14.0 years, 68,813 [43.6%] women), and 150,807 CTRLs (43.0±17.4 years; 88,540 [58.7%] women). After propensity score matching, the risk of composite outcome in patients with SVT was higher than that in CTRLs (HR 2.89; 95% CI 2.65–3.17) but lower than that in patients with atrial flutter (HR 0.87; 95% CI 0.79–0.97) and those with AF (HR 0.69; 95% CI 0.65–0.73). The risk of adverse events in patients with SVT was more pronounced during the first 30 days in males, those aged ≥65 years, or those with multimorbidity. Patients with SVT had an increased risk of incident AF than did CTRLs. Conclusion The increased risk of adverse events in patients with SVT appears to be most pronounced in the short term and partly associated with the increased likelihood of incident AF.

KW - All-cause death

KW - Atrial fibrillation

KW - Atrial flutter

KW - Supraventricular tachycardia

KW - Thromboembolism

UR - https://www.scopus.com/pages/publications/85212604003

U2 - 10.1016/j.hrthm.2024.11.044

DO - 10.1016/j.hrthm.2024.11.044

M3 - Journal article

C2 - 39613203

SN - 1547-5271

VL - 22

SP - 1504

EP - 1511

JO - Heart Rhythm

JF - Heart Rhythm

IS - 6

ER -

Risk of death and thrombosis in patients admitted to the emergency department with supraventricular tachycardias

Abstract

Bibliographical note

Keywords

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