title: High-dose sotalol is safe and effective in neonates and infants with refractory supraventricular tachyarrhythmias.
abstract: Our objective was to assess the efficacy and safety of high-dose sotalol in neonates and infants with refractory supraventricular tachycardia (SVT). SVT in neonates and infants can be refractory to primary therapies; therefore, secondary agents, e.g., sotalol, are often required to obtain control of SVT. Age-factor nomogram dosing of sotalol is widely used; however, our institution uses greater doses based on body surface area (approximately 150-200 mg/m(2)/d). A retrospective review of 78 inpatients receiving sotalol, after failing another antiarrthymic medication, at our institution from 2001 to 2008 was performed. Corrected QT intervals (QTc), 24-h Holter-monitoring results, and outpatient records were reviewed to assess safety and efficacy for patients ≤ 2 years of age. Median patient age at the time of initiation of therapy was 24 days (range 3-728). Forty-eight patients (62%) were neonates, and 36 (46%) had congenital heart disease. The median sotalol dosage was 152 mg/m(2)/day (range 65-244). The SVT of 70 patients (90%) was controlled with sotalol. No patients experienced significant QTc prolongation or proarrhythmia. Mean duration of follow-up was 3.3 ± 0.24 years. High-dose sotalol allows for safe and rapid control of refractory tachyarrhythmias in this young age group.
authors.affiliation: Department of Pediatric Cardiology, Baylor College of Medicine/Texas Children's Hospital, 6621 Fannin St, MC-19345-C, Houston, TX 77030, USA. knudson@bcm.edu
authors.forename: Jarrod D
authors.initials: JD
authors.lastname: Knudson
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Cannon
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Kim
authors.forename: Brady S
authors.initials: BS
authors.lastname: Moffett
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications* / Q000175:diagnosis; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013015:Sotalol / Q000008:administration & dosage*; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol