Sotalol, a nonselective beta blocking agent with additional Class III activity has been shown to be extremely effective in the treatment of
supraventricular tachycardias in adults and children. Little information is available on its use in infants. From August, 1985 to April, 1990, 18 infants, 2 months of age or less, were treated with oral
sotalol for supraventricular arrhythmias. Their age ranged from a few hours to 2 months, mean 5 weeks, at the start of treatment. Weights were between 2.58-5 kg, mean 3.9 kg and dosage 2-4 mg/kg/24 hrs given in two equal doses, 12 hourly. Sixteen infants had structurally normal hearts, one had multiple cardiac
rhabdomyomas, and one was postoperative
Mustard procedure for transposition of the great arteries. Thirteen of 18 infants had reentrant forms of
supraventricular tachycardia, six of these had overt preexcitation. Two infants had chaotic atrial
tachycardia, two
atrial flutter, and one with
ectopic atrial tachycardia. Previous antiarrhythmic
therapy had been unsuccessful in 12 patients. All infants, except one with chaotic atrial
tachycardia, were successfully controlled with
sotalol. Ten infants discontinued
therapy between the ages of 7 and 18 months as it was felt to be no longer necessary. Mean
duration of treatment was 12.8 months. Three had recurrences of their
arrhythmia and were again successfully controlled by
sotalol. Mild sinus
bradycardia occurred in all infants. No other side effects were noted.
Sotalol is an effective, safe
drug for the treatment of
supraventricular tachycardias in early infancy.