Document Detail


Amiodarone used alone or in combination with propranolol: a very effective therapy for tachyarrhythmias in infants and children.
MedLine Citation:
PMID:  9770567     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of the study was to evaluate the efficacy of amiodarone used alone or in combination with propranolol in infants and children affected by life-threatening or drug-resistant tachyarrhythmias. The study included 27 children (median age 3 months), affected by life-threatening and/or drug-resistant supraventricular or ventricular tachyarrhythmias. The loading dose of amiodarone was 10-20 mg/kg/day and the maintenance dose ranged between 3 and 20 mg/kg/day. When amiodarone was ineffective, propranolol was added at a dosage of 2-4 mg/kg/day. The study population was divided into two groups: group A was composed of patients <1 year and group B of patients >1 year. The effectiveness of the therapy was assessed by clinical evaluation, Holter monitoring, exercise testing, and, in patients with reentry tachycardias, electrophysiological testing. Amiodarone used alone was effective or partially effective in 4/14 (28%) patients in group A and in 11/13 (85%) patients in group B (p < 0.006). Among amiodarone-resistant patients, the combined therapy with propranolol was effective in 8/10 patients in group A and 2/2 patients in group B. Therefore, amiodarone used alone or in combination with propranolol was effective in 25/27 (93%) patients. During the follow-up (20.5 +/- 13 months) there were no arrhythmic effects but side effects were noted in 5/27 (18.5%) patients. Amiodarone seems to be an effective drug in the control of the life-threatening and/or drug-resistant supraventricular and ventricular tachyarrhythmias in children. The addition of propranolol can significantly enhance the success rate of this class III drug, especially in the treatment of reentry tachycardias due to accessory pathways.
Authors:
F Drago; A Mazza; P Guccione; A Mafrici; G Di Liso; P Ragonese
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric cardiology     Volume:  19     ISSN:  0172-0643     ISO Abbreviation:  Pediatr Cardiol     Publication Date:    1998 Nov-Dec
Date Detail:
Created Date:  1999-01-04     Completed Date:  1999-01-04     Revised Date:  2008-02-20    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  445-9     Citation Subset:  IM    
Affiliation:
Pediatric Cardiology Department, Bambino Gesù Hospital, Piazza Sant'Onofrio 4, 00165 Rome, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Amiodarone / administration & dosage*,  adverse effects
Anti-Arrhythmia Agents / administration & dosage*,  adverse effects
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Electrocardiography, Ambulatory / drug effects
Female
Humans
Infant
Infant, Newborn
Male
Propranolol / administration & dosage*,  adverse effects
Tachycardia, Supraventricular / drug therapy*,  etiology
Tachycardia, Ventricular / drug therapy*,  etiology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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