Houyel L, Fournier A, Ducharme G, Chartrand C, Davignon A
Division of Pediatric Cardiology, Sainte-Justine Hospital, Montreal, Canada.
J Cardiovasc Pharmacol. 1992 Jan;19(1):134-9. doi: 10.1097/00005344-199201000-00019.
Sotalol is a beta-blocker with class III antiarrhythmic properties that has recently been used in children for the treatment of supraventricular and ventricular arrhythmias. However, little is known about its electrophysiologic effects on the immature heart. Using intracardiac electrocardiographic recordings and stimulation techniques, 15 canine neonates (8-15 days) and 15 adult mongrel dogs were studied with cumulative doses of sotalol (0.5, 1, 2, and 4 mg/kg plus an additional dose of 8 mg/kg for neonates). Heart rate decreased significantly in the two groups, but more in adult dogs (-43% in adult dogs versus -25% in neonates, p less than 0.05). There was no significant change for QRS duration and His-Purkinje system conduction time interval. QT and atrioventricular nodal conduction time intervals increased in adult dogs and neonates. Sinus node recovery time increased significantly in the two groups, but more in adult dogs. Refractory periods of the atrioventricular (AV) node increased significantly in neonates. Atrial flutter was no longer inducible in 12 of 15 neonates after the 2 mg/kg dose. Atrial effective refractory period increased significantly more in neonates (96%, p less than 0.001) than in adult dogs (58%, p less than 0.001). Ventricular effective refractory periods increased significantly both in neonates (46%) and adult dogs (50%), in a similar way. In conclusion, sotalol has greater electrophysiologic effects on the immature heart at the atrial level when compared to the adult, and similar effects on the refractory period of AV node and ventricle.
索他洛尔是一种具有Ⅲ类抗心律失常特性的β受体阻滞剂，最近已用于儿童治疗室上性和室性心律失常。然而，关于其对未成熟心脏的电生理作用知之甚少。采用心内心电图记录和刺激技术，对15只犬龄新生儿（8 - 15天）和15只成年杂种犬进行了研究，给予累积剂量的索他洛尔（0.5、1、2和4mg/kg，新生儿额外给予8mg/kg剂量）。两组心率均显著下降，但成年犬下降更多（成年犬下降43%，新生儿下降25%，p<0.05）。QRS波时限和希氏 - 浦肯野系统传导时间间隔无显著变化。成年犬和新生儿的QT间期和房室结传导时间间隔均增加。两组窦房结恢复时间均显著增加，但成年犬增加更多。新生儿房室结的不应期显著增加。给予2mg/kg剂量后，15只新生儿中有12只不再能诱发心房扑动。新生儿心房有效不应期增加幅度（96%，p<0.001）显著大于成年犬（58%，p<0.001）。新生儿（46%）和成年犬（50%）的心室有效不应期均以相似方式显著增加。总之，与成年心脏相比，索他洛尔对未成熟心脏的心房水平电生理作用更大，而对房室结和心室不应期的作用相似。
