Efficacy and safety of propafenone in congenital junctional ectopic tachycardia.
OBJECTIVE
Class IC antiarrhythmic drugs have recently been shown to be effective in some patients with atrial ectopic tachycardia. We therefore studied the efficacy of these drugs in patients with congenital junctional ectopic tachycardia.


BACKGROUND
Follow-up data on patients with junctional ectopic tachycardia suggest that this potentially lethal arrhythmia may cease spontaneously in a significant proportion of affected children. Therefore, temporary antiarrhythmic treatment appears to be the therapy of choice.


METHODS
The efficacy of propafenone was prospectively assessed in four infants with junctional ectopic tachycardia (ventricular rate 180, 185, 210 and 320 beats/min, respectively). The diagnosis of junctional ectopic tachycardia was established before the age of 2 months in all four infants. Propafenone was given orally in a mean dose of 350 (300 to 500) mg/m2 body surface area per day. Success of therapy was determined by serial electrocardiograms (ECGs) and Holter ambulatory ECG monitoring.


RESULTS
In two patients, junctional ectopic tachycardia was completely suppressed. In the remaining two patients, the tachycardia rate decreased to less than 150 beats/min. Serum propafenone levels did not correlate with efficacy of treatment. The mean duration of therapy was 18 months (range 3 to 36). No chemical or clinical side effects were noted.


CONCLUSIONS
Because of its effectiveness, safety and lack of side effects, propafenone appears to be a valuable drug in the treatment of junctional ectopic tachycardia in newborns and infants.
Paul
T
T
Children's Hospital, Hannover Medical School, Germany.
Reimer
A
A
Janousek
J
J
Kallfelz
H C
HC
D004341:Drug Evaluation; D004562:Electrocardiography / Q000379:methods; D015716:Electrocardiography, Ambulatory; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011405:Propafenone / Q000008:administration & dosage / Q000627:therapeutic use*; D011446:Prospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000151:congenital* / Q000188:drug therapy* / Q000453:epidemiology; D013997:Time Factors
D011405:Propafenone