title: The efficacy of amiodarone-propranolol combination for the management of childhood arrhythmias.
abstract: BACKGROUND
  The aim of this study was to present our data regarding the efficacy and safety of combining amiodarone and propranolol for the management of arrhythmias in infants.
  
  
  METHODS
  Children aged between 0 and 18 years who received combination therapy with amiodarone and propranolol for persistent monotherapy resistance tachyarrhythmia between 2007 and 2011 were included in the study. Treatment efficacy and adverse effects were evaluated by review of clinical signs and symptoms, 12-lead electrocardiogram, 24-hour Holter monitorization, liver enzymes, thyroid function tests, chest x-ray, and ophthalmologic examination.
  
  
  RESULTS
  A total of 25 patients (15 male and 10 female) were enrolled in this study with a mean age of 17.9 months (0-132) and a mean weight of 8.65 kg (2.2-25). In 18 patients, treatment was started before their first age. Tachyarrhythmia persisted in two patients despite combination therapy, and treatment regimen was changed. Complete control of the arrhythmia was achieved within the first 2 months of combination treatment in 20 patients, whereas in the remaining three patients short attacks of tachycardia who responded to dose increases were controlled beyond 2 months of treatment and no recurrence were observed. Overall, success of amiodarone-propranolol combination treatment was 92%. Mild elevation in thyroid-stimulating hormone level was observed in one patient that required discontinuation of treatment.
  
  
  CONCLUSIONS
  Our results suggest that a combination of amiodarone and propranolol is an effective and safe option for the treatment of persistent arrhythmias in neonates and infants, and may serve as a bridge to ablation therapy in older children.
authors: Department of Pediatric Cardiology, Hacettepe University Faculty of Medicine, Ihsan Doğramacı Childrens Hospital, Ankara, Turkey.
authors: Alper
authors: A
authors: Akin
authors: Tevfik
authors: T
authors: Karagöz
authors: Hayrettin Hakan
authors: HH
authors: Aykan
authors: Sema
authors: S
authors: Özer
authors: Dursun
authors: D
authors: Alehan
authors: Süheyla
authors: S
authors: Özkutlu
mesh_terms: D000293:Adolescent; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011433:Propranolol / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D011433:Propranolol; D000638:Amiodarone