Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Lillie Frank Abercrombie Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
Heart Rhythm. 2018 Dec;15(12):1862-1869. doi: 10.1016/j.hrthm.2018.07.010. Epub 2018 Jul 10.
Arrhythmias are common in the pediatric population. In patients unable to take oral medications or in need of acute therapy, options of intravenous (IV) antiarrhythmic medications are limited. Recently IV sotalol has become readily available, but experience in children is limited.
The purpose of this study was to describe our initial experience with the use of IV sotalol in the pediatric population.
A retrospective study of all pediatric patients receiving IV sotalol was performed. Patient demographic characteristics, presence of congenital heart disease, arrhythmia type, efficacy of IV sotalol use, and adverse effects were evaluated.
A total of 47 patients (26 (55%) male and 24 (51%) with congenital heart disease) received IV sotalol at a median age of 2.05 years (interquartile range 0.07-10.03 years) and a median weight of 12.8 kg (interquartile range 3.8-34.2 kg), and 13 (28%) received IV sotalol in the acute postoperative setting. Supraventricular arrhythmias occurred in 40 patients (85%) and ventricular tachycardia in 7 (15%). Among 24 patients receiving IV sotalol for an active arrhythmia, acute termination was achieved in 21 (88%). Twenty-three patients received IV sotalol as maintenance therapy for recurrent arrhythmias owing to inability to take oral antiarrhythmic medications; 19 (83%) were controlled with sotalol monotherapy. No patient required discontinuation of IV sotalol secondary to adverse effects, proarrhythmia, or QT prolongation.
IV sotalol is an effective antiarrhythmic option for pediatric patients and may be an excellent agent for acute termination of active arrhythmias. It was well tolerated, with no patient requiring discontinuation secondary to adverse effects.
心律失常在儿科人群中很常见。对于无法口服药物或需要急性治疗的患者，静脉（IV）抗心律失常药物的选择有限。最近，IV 索他洛尔已广泛应用，但在儿童中的经验有限。
本研究旨在描述我们在儿科人群中使用 IV 索他洛尔的初步经验。
对所有接受 IV 索他洛尔治疗的儿科患者进行回顾性研究。评估患者的人口统计学特征、先天性心脏病的存在、心律失常类型、IV 索他洛尔使用的疗效和不良反应。
共有 47 例患者（26 例（55%）男性和 24 例（51%）有先天性心脏病）接受 IV 索他洛尔治疗，中位年龄为 2.05 岁（四分位距 0.07-10.03 岁），中位体重为 12.8 公斤（四分位距 3.8-34.2 公斤），13 例（28%）在急性术后接受 IV 索他洛尔治疗。40 例（85%）患者出现室上性心律失常，7 例（15%）患者出现室性心动过速。在 24 例因心律失常而接受 IV 索他洛尔治疗的患者中，21 例（88%）急性终止。由于无法口服抗心律失常药物，23 例患者接受 IV 索他洛尔作为复发性心律失常的维持治疗；19 例（83%）患者接受索他洛尔单药治疗。无患者因不良反应、致心律失常或 QT 延长而需要停止 IV 索他洛尔治疗。
IV 索他洛尔是儿科患者有效的抗心律失常药物选择，可能是急性终止活动性心律失常的优秀药物。它具有良好的耐受性，没有患者因不良反应而需要停药。
