Experience of using propafenone in newborns and young children with arrhythmias

Aim. To evaluate the efficacy and safety of propafenone therapy in newborns and young children, including children with congenital heart defects (CHD).Material and methods. The study included 65 children with initiation of propafenone therapy at the age of 0-5 years. For diagnosis of arrhythmias and...

Full description

Saved in:
Bibliographic Details
Main Authors: T. K. Kruchina, T. S. Kovalchuk, E. S. Vasichkina, B. A. Tatarsky
Format: Article
Language:Russian
Published: «FIRMA «SILICEA» LLC 2020-08-01
Series:Российский кардиологический журнал
Subjects:
Online Access:https://russjcardiol.elpub.ru/jour/article/view/3462
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850030779696939008
author T. K. Kruchina
T. S. Kovalchuk
E. S. Vasichkina
B. A. Tatarsky
author_facet T. K. Kruchina
T. S. Kovalchuk
E. S. Vasichkina
B. A. Tatarsky
author_sort T. K. Kruchina
collection DOAJ
description Aim. To evaluate the efficacy and safety of propafenone therapy in newborns and young children, including children with congenital heart defects (CHD).Material and methods. The study included 65 children with initiation of propafenone therapy at the age of 0-5 years. For diagnosis of arrhythmias and treatment control, electrocardiography (ECG), 24-hour Holter monitoring and echocardiography were performed. The initial dose of propafenone was 5-7 mg/kg/ day; the maximum dose — 15 mg/kg/day. The dose was titrated to effective with clinical and ECG control. It was considered acceptable to increase the duration of PQ interval and QRS complex by no more than 25% of the baseline value. The adverse and arrhythmogenic effects of the drug were evaluated.Results. Indications for propafenone administration were atrial tachycardia in 29 (44,61%) children, frequent premature ventricular contractions and ventricular tachycardia in 13 (20%) children, Wolff-Parkinson-White syndrome in 13 (20%) children, and other types of supraventricular tachycardia in 10 (15,39%) children. Sixteen (24,62%) children had CHD. In 20 (30,77%) children, propafenone was administrated in the neonatal period. The duration of propafenone therapy was 17,3±15,16 months. The drug was effective in 39 (60%) children (81,25% with CHD and 53,06% without CHD), not effective enough in 14 (21,54%) children, ineffective in 12 (18,46%) children. There was no association of the effectiveness/inefficiency of propafenone depending on the age, sex and the type of arrhythmia. Five (7,69%) children had prolongation of PQ interval and/or QRS by more than 25%. Arrhythmogenic effect of propafenone was observed in 1 (1,54%) child, noncardiac adverse effects — in 3 (4,62%) children. There were no cases of sudden cardiac death.Conclusion. Propafenone is an effective antiarrhythmic drug in newborns and young children with supraventricular and ventricular arrhythmias, including children with CHD. Using propafenone may be accompanied with adverse and arrhythmogenic effects, which were observed in 6% of children and were not associated with CHD.
format Article
id doaj-art-574bef8af2ac44d580e173955f8063c3
institution DOAJ
issn 1560-4071
2618-7620
language Russian
publishDate 2020-08-01
publisher «FIRMA «SILICEA» LLC
record_format Article
series Российский кардиологический журнал
spelling doaj-art-574bef8af2ac44d580e173955f8063c32025-08-20T02:59:07Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202020-08-0125710.15829/1560-4071-2020-34622834Experience of using propafenone in newborns and young children with arrhythmiasT. K. Kruchina0T. S. Kovalchuk1E. S. Vasichkina2B. A. Tatarsky3Almazov National Medical Research Center; Children’s City Hospital №1Almazov National Medical Research CenterAlmazov National Medical Research CenterAlmazov National Medical Research CenterAim. To evaluate the efficacy and safety of propafenone therapy in newborns and young children, including children with congenital heart defects (CHD).Material and methods. The study included 65 children with initiation of propafenone therapy at the age of 0-5 years. For diagnosis of arrhythmias and treatment control, electrocardiography (ECG), 24-hour Holter monitoring and echocardiography were performed. The initial dose of propafenone was 5-7 mg/kg/ day; the maximum dose — 15 mg/kg/day. The dose was titrated to effective with clinical and ECG control. It was considered acceptable to increase the duration of PQ interval and QRS complex by no more than 25% of the baseline value. The adverse and arrhythmogenic effects of the drug were evaluated.Results. Indications for propafenone administration were atrial tachycardia in 29 (44,61%) children, frequent premature ventricular contractions and ventricular tachycardia in 13 (20%) children, Wolff-Parkinson-White syndrome in 13 (20%) children, and other types of supraventricular tachycardia in 10 (15,39%) children. Sixteen (24,62%) children had CHD. In 20 (30,77%) children, propafenone was administrated in the neonatal period. The duration of propafenone therapy was 17,3±15,16 months. The drug was effective in 39 (60%) children (81,25% with CHD and 53,06% without CHD), not effective enough in 14 (21,54%) children, ineffective in 12 (18,46%) children. There was no association of the effectiveness/inefficiency of propafenone depending on the age, sex and the type of arrhythmia. Five (7,69%) children had prolongation of PQ interval and/or QRS by more than 25%. Arrhythmogenic effect of propafenone was observed in 1 (1,54%) child, noncardiac adverse effects — in 3 (4,62%) children. There were no cases of sudden cardiac death.Conclusion. Propafenone is an effective antiarrhythmic drug in newborns and young children with supraventricular and ventricular arrhythmias, including children with CHD. Using propafenone may be accompanied with adverse and arrhythmogenic effects, which were observed in 6% of children and were not associated with CHD.https://russjcardiol.elpub.ru/jour/article/view/3462antiarrhythmic therapy, propafenone, newborns, children, cardiac arrhythmias, congenital heart defects
spellingShingle T. K. Kruchina
T. S. Kovalchuk
E. S. Vasichkina
B. A. Tatarsky
Experience of using propafenone in newborns and young children with arrhythmias
Российский кардиологический журнал
antiarrhythmic therapy, propafenone, newborns, children, cardiac arrhythmias, congenital heart defects
title Experience of using propafenone in newborns and young children with arrhythmias
title_full Experience of using propafenone in newborns and young children with arrhythmias
title_fullStr Experience of using propafenone in newborns and young children with arrhythmias
title_full_unstemmed Experience of using propafenone in newborns and young children with arrhythmias
title_short Experience of using propafenone in newborns and young children with arrhythmias
title_sort experience of using propafenone in newborns and young children with arrhythmias
topic antiarrhythmic therapy, propafenone, newborns, children, cardiac arrhythmias, congenital heart defects
url https://russjcardiol.elpub.ru/jour/article/view/3462
work_keys_str_mv AT tkkruchina experienceofusingpropafenoneinnewbornsandyoungchildrenwitharrhythmias
AT tskovalchuk experienceofusingpropafenoneinnewbornsandyoungchildrenwitharrhythmias
AT esvasichkina experienceofusingpropafenoneinnewbornsandyoungchildrenwitharrhythmias
AT batatarsky experienceofusingpropafenoneinnewbornsandyoungchildrenwitharrhythmias