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July 26, 2026Journal of Cardiothoracic SurgeryOpen Access

Syncope history linked to ~46-fold higher risk of severe arrhythmias alongside advanced heart failure.

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Why the study?

What are the independent clinical risk factors for severe arrhythmias in non-surgical pediatric patients?

Population

428 consecutive children (0–18 years) diagnosed with arrhythmia between January 2021 and October 2025

Design

Cohort

Key result

Syncope history (OR 45.84), class III-IV heart function (OR 32.97), underlying cardiac disease (OR 12.66), and infant/toddler age (OR 2.30) were independent risk factors for severe arrhythmias.

Authors

LYLiuqing YangCDCe DengBZBailing Zhang

Discussion

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Overview

May guide closer monitoring in high-risk pediatric cases; leaves open prospective validation of the model.

Key Points

  • This study aims to examine clinical characteristics and identify risk factors associated with severe arrhythmias in pediatric patients.
  • Single-center retrospective study involving 428 children (0–18 years) diagnosed with arrhythmias.
  • Participants classified as severe or non-severe based on clinical presentations.
  • Univariate and multivariate logistic regression analyses were performed.
  • Age of infants/toddlers linked to higher risk (OR 2.30, 95% CI 1.08–4.89, P < 0.05).
  • Underlying cardiac disease increased risk significantly (OR 12.66, 95% CI 6.01–26.68, P < 0.05).
  • A predictive model demonstrated strong fit (Hosmer-Lemeshow P = 0.171) and high accuracy (AUC = 0.925, 95% CI 0.893–0.958).

Study Design

Type

Observational (n=428)

Multicenter

No

Structured PICO

What are the independent clinical risk factors for severe arrhythmias in non-surgical pediatric patients?

P
Population
428 children aged 0-18 years diagnosed with arrhythmia, evaluated retrospectively to identify risk factors for severe clinical presentation.
O
Outcome
Severe arrhythmia-related clinical presentation (presence of hemodynamic instability, syncope, heart failure, or malignant arrhythmia features)composite

Main Result

Odds Ratio: 45.84 (95% CI 12.74–164.91)

p-value: p=<0.05

Infant/toddler age, underlying cardiac disease, syncope history, and advanced heart failure are independent risk factors for severe pediatric arrhythmias, which can be incorporated into a model for early high-risk identification.

Cite This Study

Yang et al. (2026) conducted an observational in Arrhythmia (n=428). Syncope history, underlying cardiac disease, infant/toddler age, and class III-IV heart function vs. Absence of these risk factors was evaluated on Severe arrhythmia-related clinical presentation (OR 45.84, 95% CI 12.74-164.91, p=<0.05). Syncope history (OR 45.84), class III-IV heart function (OR 32.97), underlying cardiac disease (OR 12.66), and infant/toddler age (OR 2.30) were independent risk factors for severe arrhythmias.

synapsesocial.com/papers/6a65a468d3aea3239cd76ff3https://doi.org/10.1186/s13019-026-04585-w
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Arrhythmias Developing in Pediatric Patients After Cardiac Surgery: A Comprehensive Review on the Risk Factors, Prevention and Management Strategies2025
  2. 2Early Currents: Developmental Electrophysiology and Arrhythmia in Pediatric Congenital Heart Disease2025
  3. 3Post-operative arrhythmia among children who undergone cardiac surgery for congenital heart disease at Cardiac Center in Ethiopia.2025
  4. 4The Contemporary and Historical Burden of Arrhythmias in Patients with Congenital Heart Disease2026
  5. 5Clinical and electrocardiographic features and results of genetic testing of children with tachy-bradycardia syndrome2025