[Results of oral sotalol therapy in children with supraventricular and ventricular arrhythmias].
Experience with oral sotalol, a beta-blocker with class III-antiarrhythmic properties, is limited in the pediatric population. Sotalol was administered to 32 patients with a mean age of 8.7 years (range 1 day-19.9 years). Mean dosage was 4.6 (1.5-9.4) mg/kg or 122.1 (52-306) mg/m2, respectively. In 27/32 patients, at least 1 antiarrhythmic agent had failed to control the dysrhythmia before sotalol was started. Cardiac diagnoses included normal heart (n = 16), status after correction of congenital heart disease (n = 13), and cardiomyopathy (n = 3). Success (based on symptoms and 24-h electrocardiogram) was achieved in 16/18 patients with reentry supraventricular tachycardia, in 7/8 patients with atrial flutter, and in 4/6 patients with ventricular tachycardia. During a mean follow-up of 15.6 (2-78) months, proarrhythmia occurred in five (16%) patients (symptomatic bradycardia n = 2, QT-prolongation and ventricular extrasystoles n = 1, ventricular extrasystoles n = 1, 2 degrees av-block n = 1), requiring dosage reduction (n = 3), cessation of treatment (n = 1) and pacemaker implantation in one patient, respectively. Symptomatic hypotension was noted in two patients, in whom therapy had to be stopped. Sotalol was a very effective agent for the treatment of various pediatric cardiac dysrhythmias. However, incidence of proarrhythmic effects warrants close electrocardiographic monitoring.
Paul
T
T
Abteilung Kinderheilkunde III, Medizinische Hochschule Hannover.
Lehmann
C
C
Pfammatter
J P
JP
Kallfelz
H C
HC
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D001282:Atrial Flutter / Q000188:drug therapy / Q000503:physiopathology; D001283:Atrioventricular Node / Q000187:drug effects / Q000503:physiopathology; D005117:Cardiac Complexes, Premature / Q000188:drug therapy / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy / Q000503:physiopathology; D013015:Sotalol / Q000008:administration & dosage* / Q000009:adverse effects; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000188:drug therapy / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000503:physiopathology; D017180:Tachycardia, Ventricular / Q000188:drug therapy* / Q000503:physiopathology
D013015:Sotalol