Incidence of Life-Threatening Events in Children with Wolff-Parkinson-White Syndrome: Analysis of a Large Claims Database.

TitleIncidence of Life-Threatening Events in Children with Wolff-Parkinson-White Syndrome: Analysis of a Large Claims Database.
Publication TypeJournal Article
Year of Publication2021
AuthorsJanson CM, Millenson ME, Okunowo O, Dai D, Christmyer Z, Tan RBianca, V Iyer R, Shah MJ, O'Byrne ML
JournalHeart Rhythm
Date Published2021 Dec 10
ISSN1556-3871
Abstract

BACKGROUND: Previous estimates of life-threatening event (LTE) risk in Wolff-Parkinson-White (WPW) are limited by selection bias inherent to tertiary referral-based cohorts.

OBJECTIVE: This analysis sought to measure LTE incidence in children with WPW in a large contemporary representative population.

METHODS: A retrospective cohort study was conducted using claims data from the IBM MarketScan® Research Databases, evaluating WPW patients (age 1-18 years) from any encounter between 1/1/2013 and 12/31/2018. Subjects with congenital heart disease (CHD) and cardiomyopathy (CM) were excluded. The primary outcome was diagnosis of ventricular fibrillation (VF); a composite outcome, LTE, was defined as occurrence of VF and/or cardiac arrest. VF and LTE rates were compared to matched representative non-WPW controls (3:1 ratio).

RESULTS: Prevalence of WPW was 0.03% (8,733/26,684,581) over median follow-up of 1.6 years (IQR 0.7-2.9). Excluding CHD/CM, 6,946 subjects were analyzed. LTE occurred in 49 subjects, including VF in 20. Incidence of VF was 0.8 events per 1000 person-years, and incidence of LTE was 1.9 events per 1000 person-years. There were no occurrences of VF in controls; rate of LTE was 70 times greater in WPW (0.7%, 95% CI: 0.5-0.9%) than in controls (0.01%, 95% CI: 0-0.02%).

CONCLUSION: Use of a large claims dataset allowed for evaluation of VF and LTE risk in an unselected pediatric WPW population. The observed range of 0.8-1.9 events per 1000 person-years is consistent with prior reports from selected populations. Comparison of event rates to matched controls confirms and quantifies the significant elevation in VF and LTE risk in pediatric WPW.

DOI10.1016/j.hrthm.2021.12.009
Alternate JournalHeart Rhythm
PubMed ID34902591