The Efficacy of Amiodarone-Propranolol Combination for the Management of Childhood Arrhythmias


AKIN A., KARAGÖZ T., AYKAN H. H., ÖZER S., ALEHAN D., Ozkutlu S.

PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, cilt.36, sa.6, ss.727-731, 2013 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 6
  • Basım Tarihi: 2013
  • Doi Numarası: 10.1111/pace.12107
  • Dergi Adı: PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.727-731
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Background The aim of this study was to present our data regarding the efficacy and safety of combining amiodarone and propranolol for the management of arrhythmias in infants. Methods Children aged between 0 and 18 years who received combination therapy with amiodarone and propranolol for persistent monotherapy resistance tachyarrhythmia between 2007 and 2011 were included in the study. Treatment efficacy and adverse effects were evaluated by review of clinical signs and symptoms, 12-lead electrocardiogram, 24-hour Holter monitorization, liver enzymes, thyroid function tests, chest x-ray, and ophthalmologic examination. Results A total of 25 patients (15 male and 10 female) were enrolled in this study with a mean age of 17.9 months (0-132) and a mean weight of 8.65 kg (2.2-25). In 18 patients, treatment was started before their first age. Tachyarrhythmia persisted in two patients despite combination therapy, and treatment regimen was changed. Complete control of the arrhythmia was achieved within the first 2 months of combination treatment in 20 patients, whereas in the remaining three patients short attacks of tachycardia who responded to dose increases were controlled beyond 2 months of treatment and no recurrence were observed. Overall, success of amiodarone-propranolol combination treatment was 92%. Mild elevation in thyroid-stimulating hormone level was observed in one patient that required discontinuation of treatment. Conclusion Our results suggest that a combination of amiodarone and propranolol is an effective and safe option for the treatment of persistent arrhythmias in neonates and infants, and may serve as a bridge to ablation therapy in older children.