Priestley K A, Ladusans E J, Rosenthal E, Holt D W, Tynan M J, Jones O D, Curry P V
Department of Cardiology, Guy's Hospital, London, U.K.
Eur Heart J. 1988 Dec;9(12):1284-90. doi: 10.1093/oxfordjournals.eurheartj.a062445.
We treated 22 children, aged 3 days to 16 years 6 months (median 11 years 1 month), with flecainide for a variety of arrhythmias where a Class I agent was indicated. In 16, conventional antiarrhythmic treatment had failed. Structural heart disease was present in nine. The arrhythmia was paroxysmal re-entry atrioventricular tachycardia in nine; paroxysmal atrial tachycardia, flutter or fibrillation in five; paroxysmal ventricular tachycardia in five and frequent ventricular extrasystoles (with couplets) in three. Sinus rhythm was achieved in all four children who received flecainide during tachycardia (three received intravenous flecainide, one oral). During follow-up of 3-24 months (median 12 months), arrhythmia control was obtained in 13 children (59%). Combination therapy was used in seven of these; with digoxin in four and a beta blocker in three. Flecainide doses used in this study ranged from 1-11 mg kg-1 day-1 (median 4 mg kg-1 day-1), 25-297 mg m-2 day-1 (median 113 mg m-2 day-1). The median, pre-dose flecainide concentration in those responding to therapy was 225 micrograms l-1 and in those failing to respond was 417 micrograms l-1. An arrhythmogenic effect occurred in one child.
我们对22名年龄在3天至16岁6个月（中位数为11岁1个月）的儿童使用氟卡尼治疗各种有指征使用I类药物的心律失常。其中16名患儿常规抗心律失常治疗失败。9名患儿存在结构性心脏病。心律失常类型为：阵发性折返性房室性心动过速9例；阵发性房性心动过速、心房扑动或心房颤动5例；阵发性室性心动过速5例；频发室性早搏（成对出现）3例。4名在心动过速期间接受氟卡尼治疗的患儿均恢复窦性心律（3例接受静脉注射氟卡尼，1例口服）。在3至24个月（中位数为12个月）的随访中，13名患儿（59%）心律失常得到控制。其中7名患儿采用了联合治疗；4名联合地高辛，3名联合β受体阻滞剂。本研究中使用的氟卡尼剂量范围为1 - 11 mg·kg⁻¹·d⁻¹（中位数为4 mg·kg⁻¹·d⁻¹），25 - 297 mg·m⁻²·d⁻¹（中位数为113 mg·m⁻²·d⁻¹）。治疗有效者给药前氟卡尼浓度中位数为225 μg·l⁻¹，治疗无效者为417 μg·l⁻¹。1名患儿出现致心律失常作用。
