Pfammatter J P, Weber J W, Stocker F P
Abteilung pädiatrische Kardiologie, Universitätskinderklinik Bern.
Klin Padiatr. 1998 Sep-Oct;210(5):358-62. doi: 10.1055/s-2008-1043903.
Supraventricular reentrant tachycardias are the most common cardiac arrhythmia observed in infancy and childhood. The often benign clinical course of the disease warrants careful selection of any antiarrhythmic drug given to prevent recurrencies, in order to avoid potentially dangerous side-effects such as proarrhythmia. This study reports our experience with atenolol in the longterm treatment of infants and children with supraventricular tachycardias.
A search of our database was made and all the children admitted in our institution between 1987 and 1995 for treatment of supraventricular tachycardia were selected. Patients who had longterm oral treatment with atenolol were retrospectively evaluated and were seen during 1996 in our outpatient clinic for a follow-up examination including a Holter-monitor.
14 infants and children with a median age of 2 9/12 years at first presentation could be evaluated. In 10 patients, atenolol was the first antiarrhythmic drug given. In 10 of the patients (72%) therapy with atenolol was considered successful and no further attacks of tachycardia occurred. In 2 patients a partial response to atenolol was seen with an important decrease in the frequency of tachycardias. Two patients showed no effect of treatment and the betablocker was withdrawn. The effect of the drug on heart rate and blood pressure was mild and did not lead to symptoms. In no case had the drug to be withdrawn for adverse effects. After a mean follow-up of 50 months (3-105 months), 7 patients were off the drug and free of recurrencies while among the 5 children still on atenolol, only one experienced rare episodes of tachycardia.
Atenolol is efficient in the longterm treatment of supraventricular tachycardias and due to its favorable risk profile can be recommended as first line treatment option.
室上性折返性心动过速是婴幼儿期最常见的心律失常。该疾病通常良性的临床病程要求在选择任何抗心律失常药物以预防复发时需谨慎，以免出现诸如促心律失常等潜在危险的副作用。本研究报告了我们使用阿替洛尔长期治疗婴幼儿和儿童室上性心动过速的经验。
检索我们的数据库，选取1987年至1995年间在我们机构因室上性心动过速入院治疗的所有儿童。对长期口服阿替洛尔治疗的患者进行回顾性评估，并于1996年在我们的门诊进行随访检查，包括动态心电图监测。
首次就诊时中位年龄为2又9/12岁的14名婴幼儿和儿童可纳入评估。10例患者中，阿替洛尔是首个给予的抗心律失常药物。10例患者（72%）使用阿替洛尔治疗被认为成功，未再发生心动过速发作。2例患者对阿替洛尔有部分反应，心动过速频率显著降低。2例患者治疗无效，停用了β受体阻滞剂。该药物对心率和血压的影响轻微，未导致症状。无一例因不良反应而停药。平均随访50个月（3 - 105个月）后，7例患者停药且无复发，而仍在使用阿替洛尔的5名儿童中，只有1例经历过罕见的心动过速发作。
阿替洛尔在室上性心动过速的长期治疗中有效，因其良好的风险特征，可推荐作为一线治疗选择。
