Mehta A V, Subrahmanyam A B, Anand R
Department of Pediatrics, James H. Quillen College of Medicine, East Tennessee State University, Johnson City 37604, USA.
Pediatr Cardiol. 1996 Jul-Aug;17(4):231-6. doi: 10.1007/BF02524799.
Propranolol, a first-generation nonselective beta-adrenoceptor blocking agent, is commonly used to treat pediatric arrhythmias. Atenolol, relatively long-acting, cardioselective beta-adrenoceptor blocking agent, has been successfully used in adults with supraventricular tachycardia (SVT). There is only one report on the use of atenolol in children with SVT; and our report is on the first long-term prospective study to evaluate the use of atenolol in children. A group of 22 children < 18 years of age with clinical SVT were enrolled in the study. The tachycardia was documented on electrocardiograms in each case and was confirmed by electrophysiologic studies in some. Once-a-day oral atenolol was started as a monotherapy. Of the 22 children with various types of SVT, 13 (59%) were well controlled on long-term oral atenolol therapy. The effective dose of atenolol ranged between 0.3 and 1.3 mg/kg/day (median effective dose 0.7 mg/kg/day). Five children had some adverse effects. However, none in the successful group of 13 patients required drug discontinuation because of such effects. Once-a-day oral atenolol as a monotherapy is effective and relatively safe for long-term management of SVT during childhood. It is an attractive alternative beta-adrenoceptor blocking agent for the management of pediatric arrhythmias.
普萘洛尔，第一代非选择性β肾上腺素能受体阻滞剂，常用于治疗小儿心律失常。阿替洛尔，作用时间相对较长的心脏选择性β肾上腺素能受体阻滞剂，已成功用于治疗成人室上性心动过速（SVT）。关于阿替洛尔用于小儿SVT的报道仅有一例；而我们的报道是关于评估阿替洛尔在儿童中应用的首个长期前瞻性研究。一组22名年龄小于18岁的临床诊断为SVT的儿童纳入该研究。每例患儿均通过心电图记录心动过速情况，部分患儿通过电生理研究得以证实。开始采用每日一次口服阿替洛尔进行单一疗法治疗。在这22例患有各种类型SVT的儿童中，13例（59%）在长期口服阿替洛尔治疗后病情得到良好控制。阿替洛尔的有效剂量范围为每日0.3至1.3毫克/千克（中位有效剂量为每日0.7毫克/千克）。5名儿童出现了一些不良反应。然而，在成功治疗的13例患儿中，无人因这些不良反应而停药。每日一次口服阿替洛尔单一疗法对于儿童期SVT的长期治疗有效且相对安全。它是治疗小儿心律失常的一种有吸引力的β肾上腺素能受体阻滞剂替代药物。
