High-dose sotalol is safe and effective in neonates and infants with refractory supraventricular tachyarrhythmias.

Abstract

Our objective was to assess the efficacy and safety of high-dose sotalol in neonates and infants with refractory supraventricular tachycardia (SVT). SVT in neonates and infants can be refractory to primary therapies; therefore, secondary agents, e.g., sotalol, are often required to obtain control of SVT. Age-factor nomogram dosing of sotalol is widely used; however, our institution uses greater doses based on body surface area (approximately 150-200 mg/m(2)/d). A retrospective review of 78 inpatients receiving sotalol, after failing another antiarrthymic medication, at our institution from 2001 to 2008 was performed. Corrected QT intervals (QTc), 24-h Holter-monitoring results, and outpatient records were reviewed to assess safety and efficacy for patients ≤ 2 years of age. Median patient age at the time of initiation of therapy was 24 days (range 3-728). Forty-eight patients (62%) were neonates, and 36 (46%) had congenital heart disease. The median sotalol dosage was 152 mg/m(2)/day (range 65-244). The SVT of 70 patients (90%) was controlled with sotalol. No patients experienced significant QTc prolongation or proarrhythmia. Mean duration of follow-up was 3.3 ± 0.24 years. High-dose sotalol allows for safe and rapid control of refractory tachyarrhythmias in this young age group.

• Authors: Jarrod D Knudson, Bryan C Cannon, Jeffrey J Kim, Brady S Moffett
• Journal: Pediatric cardiology (Pediatr Cardiol) Vol. 32 Issue 7 Pg. 896-903 (Oct 2011) ISSN: 1432-1971 [Electronic] United States
• PMID: 21553267 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Sotalol

Topics

• Anti-Arrhythmia Agents (administration & dosage)
• Child, Preschool
• Dose-Response Relationship, Drug
• Electrocardiography, Ambulatory (drug effects)
• Female
• Follow-Up Studies
• Heart Defects, Congenital (complications, diagnosis)
• Heart Rate (drug effects)
• Humans
• Infant
• Infant, Newborn
• Male
• Retrospective Studies
• Sotalol (administration & dosage)
• Tachycardia, Supraventricular (drug therapy, etiology, physiopathology)
• Treatment Outcome