Colloridi V, Boscioni M, Patruno N, Pulignano G, Critelli G
Department of Cardiology and Cardiovascular Surgery, University of Rome La Sapienza, Italy.
Pediatr Cardiol. 1990 Oct;11(4):213-5. doi: 10.1007/BF02238370.
A newborn infant with familial Wolff-Parkinson-White (WPW) syndrome presented with a supraventricular tachycardia of 300 beats/min, refractory to digoxin and flecainide administration. Serial electropharmacologic tests were performed via the esophagus before and during oral therapy with verapamil at 40, 80, and 60 mg daily. Before treatment, tachycardia could be induced with programmed stimulation. A regimen of verapamil at 60 mg daily, which resulted in the initiation of nonsustained (less than 10 s) reciprocating tachycardia only, without clinical recurrences, was identified as suitable long-term oral therapy. The efficacy of this drug regimen in preventing episodes of tachycardia was confirmed during a 1-month follow-up period. It is concluded that transesophageal atrial pacing is a useful, noninvasive means of selecting treatment in neonates with supraventricular tachycardia, when nonconventional drugs are considered for prophylaxis.
一名患有家族性预激综合征（WPW）的新生儿出现了室上性心动过速，心率为每分钟300次，对给予地高辛和氟卡尼治疗无效。在口服维拉帕米治疗期间，分别按照每日40毫克、80毫克和60毫克的剂量，于治疗前和治疗期间通过食管进行了系列电药理学测试。治疗前，通过程控刺激可诱发心动过速。确定每日60毫克维拉帕米的治疗方案为合适的长期口服治疗方案，该方案仅引发了非持续性（少于10秒）折返性心动过速，且无临床复发情况。在1个月的随访期内证实了该药物方案预防心动过速发作的疗效。结论是，当考虑使用非常规药物进行预防时，经食管心房起搏是一种有用的、非侵入性的方法，可用于选择治疗新生儿室上性心动过速。
