title: Experience with Holter monitoring during propranolol therapy for infantile hemangiomas.
abstract: BACKGROUND
  Although adverse events in children treated with propranolol have proven rare, the appropriate methods of assessing cardiovascular risk and monitoring for toxicity when the medication is used for infantile hemangiomas remain unclear.
  
  
  OBJECTIVE
  We sought to analyze Holter monitor reports of otherwise healthy patients on propranolol for infantile hemangiomas to determine the incidence of sustained arrhythmias and to evaluate the utility of Holter monitoring in the outpatient setting.
  
  
  METHODS
  We retrospectively reviewed the charts of patients with infantile hemangioma who underwent 24-hour Holter monitoring after initiation or dose escalation of propranolol between 2011 and 2014.
  
  
  RESULTS
  In all, 43 patients aged 1.8 to 36.2 months, with 44 Holter monitor reports, were included in the study. No sustained arrhythmias were revealed. The treatment plan was not altered in any patient based on the Holter monitor report.
  
  
  CONCLUSIONS
  This was a retrospective study design.
  
  
  CONCLUSIONS
  Our study suggests that Holter monitoring may be unnecessary in otherwise healthy patients with infantile hemangioma older than 12 weeks who are treated with propranolol in the outpatient setting.
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio; University of Mississippi Medical Center, Jackson, Mississippi.
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Jacks
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Naomi J
authors.initials: NJ
authors.lastname: Kertesz
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Witman
authors.affiliation: Nationwide Children's Hospital, Columbus, Ohio. Electronic address: Esteban.fernandezfaith@nationwidechildrens.org.
authors.forename: Esteban
authors.initials: E
authors.lastname: Fernandez Faith
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D000367:Age Factors; D000553:Ambulatory Care / Q000379:methods; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology; D002675:Child, Preschool; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D015716:Electrocardiography, Ambulatory / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D018324:Hemangioma, Capillary / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009386:Neoplastic Syndromes, Hereditary / Q000175:diagnosis / Q000188:drug therapy*; D061214:Patient Safety; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D014481:United States; D019564:Unnecessary Procedures
chemical_list: D000319:Adrenergic beta-Antagonists; D011433:Propranolol
keywords: infantile hemangiomas; medication safety; pediatric dermatology; propranolol; systemic therapies; vascular lesions