Sotalol for refractory arrhythmias in pediatric and young adult patients: initial efficacy and long-term outcome.
Sotalol for refractory arrhythmias in pediatric and young adult patients: initial efficacy and long-term outcome.
复制标题
索他洛尔治疗儿童和年轻成人患者难治性心律失常：初步疗效和长期结果。
DOI：
10.1016/0002-8703(95)90079-9
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发表时间：
1995
影响因子：
4.8
通讯作者：
Saul,JP
中科院分区：
文献类型：
--
作者：
Tanel,RE;Walsh,EP;Lulu,JA;Saul,JP
索他洛尔是一种抗心律失常药物，兼有β阻滞剂和III类药物的特性，已被安全有效地用于治疗儿科患者多种机制的心律失常。这项研究的目的是回顾我们在45例难治性心律失常患者中使用索他洛尔的机构经验，并确定他们的长期结果。患者对索他洛尔的有效率为80%，不良反应发生率为22%。索他洛尔平均剂量116 mg/m2/d，平均疗程15.2个月。尽管有80%的有效率，但只有22%的患者长期服用索他洛尔。索他洛尔停用最常见的原因是疾病的自发缓解或射频消融的最终治愈。终止有效治疗的其他原因包括不良副作用和使用抗心动过速起搏器或其他药物控制心律失常。一名患者在服用索他洛尔时死亡，但这一病例被认为是治疗失败，而不是副作用。在仍在接受治疗的患者中，有几人患有复杂的结构性心脏病，需要包括索他洛尔在内的综合治疗才能充分控制心律。
Sotalol is an antiarrhythmic medication that has properties of both a β-blocker and a class III agent and has been used safely and effectively to treat arrhythmias of multiple mechanisms in pediatric patients. The purpose of this study was to review our institutional experience with sotalol in 45 patients with refractory arrhythmias and determine their long-term outcome. Patients responded to sotalol with 80% efficacy and a 22% incidence of adverse side effects. The mean sotalol dose was 116 mg/m2/day, and the average duration of therapy was 15.2 months. In spite of 80% efficacy, only 22% of patients remained on sotalol long-term. Sotalol was discontinued most commonly for either spontaneous resolution of disease or definitive cure by radiofrequency ablation. Other reasons for discontinuation of effective therapy included adverse side effects and arrhythmia control with either an antitachycardia pacemaker or another medication. One patient died while taking sotalol, but this case was considered a failure of treatment rather than an adverse side effect. Of the patients who still receive therapy, several have complex structural heart disease and require a combination of therapies, including sotalol, for adequate rhythm control.