Author + information
- Received September 18, 2019
- Revision received November 27, 2019
- Accepted November 28, 2019
- Published online April 20, 2020.
- Alejandro A. Borquez, MD∗ (, )
- Othman A. Aljohani, MD,
- Matthew R. Williams, MD and
- James C. Perry, MD
- Division of Pediatric Cardiology, Department of Pediatrics, University of California-San Diego School of Medicine, Rady Children's Hospital, San Diego, California
- ↵∗Address for Correspondence:
Dr. Alejandro Borquez, University of California-San Diego School of Medicine, Rady Children's Hospital, 3020 Children’s Way, Mail Code 5004, San Diego, California 92123.
Objectives This study assessed the safety and efficacy of novel and standardized protocols for the use of intravenous (IV) sotalol in pediatric patients.
Background Acute arrhythmia treatments in children remain limited. IV sotalol is a new option but pediatric experience is limited. There is no standardized protocol for rapid infusion during acute arrhythmias. This study assessed a single center’s initial experience with IV sotalol in young patients, describing a protocol for rapid infusion for acute treatment, and reviewed the safety and efficacy of maintenance dosing.
Methods This is a retrospective study of all patients who received IV sotalol at Rady Children’s Hospital. Demographics, arrhythmia, hemodynamics, and effects of IV sotalol were assessed.
Results Thirty-seven patients received IV sotalol from December 2015 to December 2018. Group 1 (n = 26) received sotalol for acute therapy and group 2 (n = 11) received a maintenance dose of sotalol after successful cardioversion with alternate therapies. The groups had similar demographics. Group 1 included patients with atrial flutter (n = 16), patients with supraventricular tachycardia (SVT) (n = 9), and patients with atrial ectopic tachycardia (AET) (n = 1). All 9 patients with SVT (100%) converted to sinus rhythm after failure to convert using adenosine. Median administration time was 15 min, the median dose was 30 mg/m2, and mean time to cardioversion was 14 min. Group 2 median infusion time was 120 min, the median dose was 54 mg/m2/day, and all patients maintained sinus rhythm. No patients required cessation for adverse effects previously described for IV sotalol.
Conclusions IV sotalol was safe and effective for acute and maintenance therapy in young patients. In acute patients, 30 mg/m2 over 15 min converted most patients. IV sotalol adds a valuable option to IV therapies in the young.
- atrial flutter, congenital heart disease
- supraventricular tachycardia
This study was supported by AltaThera Pharmaceuticals. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received September 18, 2019.
- Revision received November 27, 2019.
- Accepted November 28, 2019.
- 2020 American College of Cardiology Foundation
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