Is paroxysmal supraventricular tachycardia truly benign? Insightful association between PSVT and stroke from a National
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Is paroxysmal supraventricular tachycardia truly benign? Insightful association between PSVT and stroke from a National Inpatient Database Study Sharan Prakash Sharma 1 & Ashok Kondur 1 & Rakesh Gopinathannair 2 & Timothy Kamerzell 3 & Moussa Mansour 4 & Srijoy Mahapatra 5 & Krzysztof Bartus 6 & Dhanunjaya Lakkireddy 2 Received: 26 June 2019 / Accepted: 16 October 2019 # Springer Science+Business Media, LLC, part of Springer Nature 2019
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. Keywords Paroxysmal supraventricular tachycardia . Ischemic stroke . Embolic stroke . National Inpatient database Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10840-019-00651-7) contains supplementary material, which is available to authorized users. * Dhanunjaya Lakkireddy [email protected] 1
Division of Cardiovascular Medicine, Garden City Hospital, Garden City, MI, USA
2
The Kansas City Heart Rhythm Institute, HCA MidWest Health, 12200 West 106th Street, Suite 320, Overland Park, KS, Overland Park, KS 661215, USA
3
Quivira Internal Medicine, Overland Park Regional Medical Center, Overland Park, KS, USA
4
Section of Electrophysiology, Massachusetts General Hospital, Boston, MA, USA
5
Abbott Laboratories, Minneapolis, MN, USA
6
Department of Cardiovascular Surgery and Transplantology, Jagiellonian University Medical College, John
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