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American Heart Association

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Final ID: MDP339

Socioeconomic status, race, and ethnicity in management of pediatric SVT

Abstract Body (Do not enter title and authors here): Introduction: Electrophysiology study and ablation (EPS) is often the preferred approach to management of supraventricular tachycardia (SVT) and/or ventricular pre-excitation (WPW) in older children/adolescents. There are inequities in arrhythmia management in adults, and in other areas of pediatric cardiology, but little is known about disparities in management of SVT in children.
Research question: Do racial/ethnic and socioeconomic inequities affect referral for EPS in patients with SVT and/or WPW?
Methods: This retrospective observational study utilized the Pediatric Health Information System of 49 children’s hospitals’ administrative data from 2016-2022. We included patients with SVT or WPW seen in the emergency department, admitted for observation, or inpatient. We excluded patients with congenital heart disease. The outcome was having a procedure code for EPS. The childhood opportunity index (COI, scale 1-100) based on zip code was used to measure socioeconomic status (SES).
Results: Among 37,818 patients with primary diagnosis of SVT (27620, 73%) or WPW (10198, 27%), 9840 (26%) underwent EPS (Table 1). COI was higher in patients who underwent EPS than those who did not (median 59 [IQR 34,82] vs 57 [IQR 30,81]). In addition, time from initial visit with diagnosis of SVT/WPW to EPS was longer in patients with lower COI (beta= -0.026, p=0.007). Black (21.2%), Hispanic (23.8%), and American Indian (19.8%) patients were less likely to undergo EPS than White (26.5%) and Asian (28.31%) patients and those with other (28.4%) or unknown/missing (35.7%) race (p<0.001, Figure 1). In both subgroups of patients with SVT and WPW, EPS differed by race and COI, and higher COI predicted shorter time to EPS.
Conclusions: In this hospital database of pediatric patients, we found disparities in use of EPS for the management of SVT and/or WPW. Patients of minoritized race/ethnicity and lower SES were less likely to undergo EPS.
  • Javalkar, Karina  ( Boston Childrens Hospital , Somerville , Massachusetts , United States )
  • Sleeper, Lynn  ( Boston Childrens Hospital , Somerville , Massachusetts , United States )
  • Newburger, Jane  ( Boston Childrens Hospital , Somerville , Massachusetts , United States )
  • Dionne, Audrey  ( Boston Childrens Hospital , Somerville , Massachusetts , United States )
  • Author Disclosures:
    Karina Javalkar: DO NOT have relevant financial relationships | Lynn Sleeper: No Answer | Jane Newburger: DO have relevant financial relationships ; Research Funding (PI or named investigator):Pfizer:Active (exists now) ; Royalties/Patent Beneficiary:UpToDate:Active (exists now) ; Other (please indicate in the box next to the company name):Daichii Sankyo (trial Steering Committee):Past (completed) ; Other (please indicate in the box next to the company name):BMS (Chair of DSMB for pediatric mavacamten trial):Active (exists now) ; Other (please indicate in the box next to the company name):Novartis (Chair, Independent EAC):Past (completed) ; Other (please indicate in the box next to the company name):BMS (Chair, Independent EAC):Active (exists now) ; Other (please indicate in the box next to the company name):Pfizer (Chair Independent EAC):Active (exists now) | Audrey Dionne: DO have relevant financial relationships ; Research Funding (PI or named investigator):Boston Scientific:Active (exists now) ; Research Funding (PI or named investigator):Pfizer:Active (exists now)
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Pediatric Surgery, Cath, and EP

Saturday, 11/16/2024 , 12:50PM - 02:15PM

Moderated Digital Poster Session

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