[Amiodarone for long term treatment of arrhythmia in children].

Amiodarone was used in 37 pediatric subjects aging 1 day--16 years. Very high efficiency of long-term treatment (mean 8 months) was found in the cases of supraventricular as well as ventricular tachyarrhythmias (paroxysmal and nonparoxysmal) including complex life-threatening ones. The treatment was not effective only in three subjects. In the other cases normal heart rhythm was achieved or duration time and number of tachycardia attacks was reduced. The class of arrhythmia improved. It was often recommended to use amiodarone together with digitalis preparation in order to obtain its antiarrhythmic activity. Our usual amiodarone dose was 10-20 mg/kg of body mass/24 h intravenously (in order to interrupt the attack) or 10 mg/kg/24 h per os in saturation period. Then the daily dose was reduced to the mean equal 5 mg/kg. Amiodarone side effects were observed in rather high percentage of subjects (24%) during long-term treatment. There were abnormal laboratory tests or laboratory and clinical abnormalities of thyroid function observed in 3 cases. In 4 other ones amiodarone deposits in cornea were found. They disappeared in 2 cases after drug dose reduction. In 1 child the symptoms of lung fibrosis and in the other one of sunshine hypersensitivity were observed. Thus, because of side effects treatment had to be interrupted in 7 cases (19%). It is concluded that amiodarone is exceptionally effective antiarrhythmic drug, very useful also in the youngest pediatric patients. On the other hand it is concluded, that the treated subjects must remain under careful medical control because of high rate of amiodarone side effects.