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Utility of routine electrocardiographic screening before initiation of propranolol for infantile hemangiomas

Emily B Lund1, Sarah L Chamlin2,3, Anthony J Mancini2,3

  • 1Section of Dermatology, University of Chicago Pritzker School of Medicine, Chicago, IL, USA.

Pediatric Dermatology
|April 24, 2018
PubMed

Insights

Screening electrocardiograms before propranolol treatment for infantile hemangiomas are not necessary. Abnormal ECGs were common but did not reveal contraindications or link to side effects in infants with hemangiomas.

Area of Science:

  • Pediatric Dermatology
  • Cardiology
  • Pharmacology

Background:

  • Infantile hemangiomas (IH) are common vascular tumors in infants.
  • Propranolol is a first-line treatment for problematic IH.
  • The need for screening electrocardiography (ECG) before propranolol initiation is debated.

Purpose of the Study:

  • To evaluate the clinical utility of pretreatment ECG in infants with IH receiving propranolol.
  • To determine if screening ECG identifies contraindications or predicts side effects.

Main Methods:

  • Retrospective chart review of infants with IH starting propranolol.
  • Analysis of pretreatment ECG findings and reported side effects.

Main Results:

  • Nearly half of the infants had abnormal screening ECGs.
  • No contraindications to propranolol treatment were identified from ECGs.
  • No association was found between abnormal ECGs and propranolol-related side effects.

Conclusions:

  • Pretreatment ECG is not necessary for most infants with IH starting propranolol.
  • Findings support previous data, confirming the low yield of screening ECGs in this population.
  • Clinical judgment should guide treatment decisions rather than routine ECG screening.

Keywords:
hemangiomastherapy systemicvascular tumors

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