Efficacy of Intravenous Sotalol for Treatment of Incessant Tachyarrhythmias in Children
| Autor: | Yi Zhang, He Jiang, Haiyan Ge, Yan Zhang, Xiaomei Li, Haiju Liu |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
Tachycardia Ectopic Atrial Tachycardia medicine.medical_specialty Time Factors Adolescent Propafenone 030204 cardiovascular system & hematology QT interval 03 medical and health sciences 0302 clinical medicine Internal medicine Atrial Fibrillation medicine Humans Tachycardia Atrioventricular Nodal Reentry Sinus rhythm cardiovascular diseases 030212 general & internal medicine Child Infusions Intravenous Atrial tachycardia business.industry Sotalol Infant Newborn Infant medicine.disease Atrioventricular reentrant tachycardia Treatment Outcome Atrial Flutter Child Preschool Anesthesia Tachycardia Ventricular cardiovascular system Cardiology Drug Therapy Combination Female medicine.symptom Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents Atrial flutter medicine.drug |
| Zdroj: | The American Journal of Cardiology. 119:1366-1370 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2017.01.034 |
| Popis: | Our objective was to evaluate the efficacy and safety of intravenous (IV) sotalol in the treatment of incessant tachyarrhythmias in children with normal cardiac function. Eighty-three children admitted to hospital from October 2011 to December 2014 were treated with IV sotalol or IV sotalol plus IV propafenone. The time to conversion to sinus rhythm and maintaining sinus rhythm were evaluated. Blood pressure, heart rate, QTc, PR intervals, and rhythm were monitored; 50 patients (60%) were converted to sinus rhythm with IV sotalol; time to conversion was 12.0 ± 18.0 hours; 12 additional patients (15%) were converted with IV sotalol combined with IV propafenone; time to conversion was 13.1 ± 17.6 hours. A total of 62 patients (75%) were converted. Success rates of IV sotalol for different tachycardias were similar, whereas the time to conversion differed. The time to conversion for atrioventricular reentrant tachycardia was shorter than atrial tachycardia or atrial flutter (p0.05). QTc prolongation (from 253 to 486 ms and from 398 ms to 500 ms) was seen in 2 patients (2%) within 48 hours after conversion. The QTc reverted to normal range at 48 and 144 hours, respectively, after withdrawal of IV sotalol. A 1 month old with atrial flutter developed bradycardia (7:1 atrioventricular conduction) 5 minutes after IV sotalol, and heart rate increased gradually after drug withdrawal. No other adverse effects were observed. In conclusion, IV sotalol can be safely and effectively used to terminate pediatric tachycardias in patients with normal cardiac function. No proarrhythmic or significant toxicities were detected. Close monitoring of QTc and heart rate is required after IV sotalol. Adding IV propafenone to IV sotalol in resistant cases enhance conversion. |
| Databáze: | OpenAIRE |
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