RT-198
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Amiodarone used alone or in
combination with propranolol: a very effective therapy for tachyarrhythmias in infants and
children
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Fabrizio Drago, Andrea Mazza,
Massimo Stefano Silvetti, Antonella Mafrici, Gaetano Di Liso, Pietro Ragonese.
Pediatric Cardiology Department, Bambino Gesu Hospital, Rome, Italy
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Abstract
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The aim of the study was to evaluate the efficacy of
amiodarone used alone or in combination with propranolol in infants and children affected
by life-threatening or drug resistant tachyarrhythmias. Twenty-seven children (median age
3 months), affected by life-threatening and/or drug resistant supraventricular or
ventricular tachyarrhythmias were treated with amiodarone (loading dose 10-20 mg/kg/day;
maintenance dose: 3-20 mg/kg/day). When amiodarone was ineffective, propranolol was added
with a dosage of 2-4 mg/kg/day. The effectiveness of the therapy was assessed by clinical
evaluation, Holter monitoring, exercise testing and, in patients with reentry
tachycardias, by electrophysiologic testing. Amiodarone used alone was effective in 15/27
(56%) patients. Among the other 12 patients, of whom 8 affected by atrioventricular
reentry tachycardia, amiodarone in combination with propranolol was effective in 10 (83%)
patients. Therefore, amiodarone used alone or in combination with propranolol was
effective in 25/27 (93%) patients. During the follow-up (17.5 ± 16 months) side effects
were noted in 5/27 (18.5%) patients. In conclusion amiodarone is effective in the control
of the life-threatening and/or drug resistant tachyarrhythmias in children. Propranolol
can significantly enhance the success rate of this class III drug, especially in the
treatment of atrioventricular reentry tachycardias.
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Key Words
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Peadiatric arrhythmias- management
ventricular/supraventricular tachyarrhythmias, amiodarone, propranolol, drug resistance,
atrioventricular reentry tachycardia, OA
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