Chemical cardioversion of atrial flutter and fibrillation in the pediatric population with Ibutilide
| Autor: | Ishaan Dave, Robert Whitehill, Peter S. Fischbach, Soham Dasgupta |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Bradycardia
Heart Defects Congenital Male Adolescent Sedation Ibutilide 030204 cardiovascular system & hematology QT interval 03 medical and health sciences Young Adult 0302 clinical medicine Atrial Fibrillation medicine Humans 030212 general & internal medicine Adverse effect Child Retrospective Studies Fibrillation Sulfonamides business.industry Infant Newborn Infant Atrial fibrillation General Medicine medicine.disease Atrial Flutter Anesthesia Child Preschool Female medicine.symptom Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Atrial flutter medicine.drug |
| Zdroj: | Pacing and clinical electrophysiology : PACEREFERENCES. 43(3) |
| ISSN: | 1540-8159 |
| Popis: | Introduction Atrial flutter (AFL) and atrial fibrillation (AF) are common in pediatric patients with congenital heart disease and structurally normal hearts as well. Chemical cardioversion is attractive for patients with AFL/AF for a short period of time because of the ability to avoid sedation. We review a single center's experience with Ibutilide in pediatric patients in an effort to report on its safety and efficacy. Methods We performed a retrospective chart review of pediatric patients (0-21 years) who underwent chemical cardioversion for AFL/AF with Ibutilide (January 2011-February 2019). Patients on another antiarrhythmic medication or attempted chemical cardioversion with another drug were excluded. Results There were 21 patients who met inclusion criteria. Thirteen of the 21 (62%) patients were successfully cardioverted with Ibutilide (10 out of 13 had AF and four out of 13 required a second dose). There were no significant differences in baseline characteristics between those who were successfully cardioverted compared to those who were not. Administration of magnesium prior to administration did not appear to have an effect on the success rate. There was a significant increase in rate corrected QT interval (QTc) post Ibutilide administration, which returned to baseline prior to discharge. One patient had symptomatic bradycardia needing intravenous fluids and another had torsades requiring electrical cardioversion during Ibutilide administration. Conclusions The success rate of chemical cardioversion with Ibutilide was similar in our experience as compared to studies in the adult population and the other lone pediatric study. Although adverse events were uncommon, Ibutilide administration warrants close monitoring and fully defining its efficacy warrants further pediatric experience. |
| Databáze: | OpenAIRE |
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