Ikuta Toshihiko, Fujioka Kazumichi, Sato Yumi, Ashina Mariko, Fukushima Sachiyo, Ohyama Shohei, Okubo Saki, Yamana Keiji, Morizane Mayumi, Tanimura Kenji, Deguchi Masashi, Iijima Kazumoto, Morioka Ichiro, Yamada Hideto
Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Department of Pediatrics, Kakogawa Central City Hospital, Kakogawa, Japan.
Kobe J Med Sci. 2018 Apr 19;63(4):E109-E112.
Congenital complete atrioventricular block (CCAVB) is a condition in which the atria and ventricles beat independently of each other. CCAVB cases require permanent pacemaker implantation until adulthood. Nevertheless, consensus regarding postnatal medical therapy for bradycardia has not been reached. Here we report the case of a newborn with CCAVB, whose intractable bradycardia was successfully treated with transdermal tulobuterol. Tulobuterol is a selective β2-adrenoceptor agonist, widely used safely as bronchodilator in children. It also has positive inotropic and chronotropic effect via β1-adrenoceptors. We believe the tulobuterol patch can be used as an optional therapy for CCAVB where pacemaker implantation is not available.
先天性完全性房室传导阻滞(CCAVB)是一种心房和心室相互独立跳动的病症。CCAVB病例在成年前需要植入永久性起搏器。然而,关于出生后心动过缓的药物治疗尚未达成共识。在此,我们报告一例CCAVB新生儿病例,其难治性心动过缓通过透皮妥洛特罗成功治疗。妥洛特罗是一种选择性β2肾上腺素能受体激动剂,在儿童中作为支气管扩张剂被广泛安全使用。它还通过β1肾上腺素能受体具有正性肌力和变时作用。我们认为,在无法进行起搏器植入的情况下,妥洛特罗贴片可作为CCAVB的一种可选治疗方法。