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The response of paediatric arrhythmias to intravenous and oral flecainide
Insights
Flecainide acetate effectively treated life-threatening paediatric arrhythmias in children. This antiarrhythmic drug showed efficacy and low toxicity, suggesting its value in managing selected pediatric heart rhythm disorders.
Area of Science:
- Pediatric Cardiology
- Clinical Pharmacology
Background:
- Arrhythmias in children can be life-threatening or resistant to standard treatments.
- Specific pediatric arrhythmias include Wolff-Parkinson-White syndrome, concealed accessory pathways, His bundle tachycardia, and ventricular tachycardia.
Purpose of the Study:
- To evaluate the efficacy and safety of flecainide acetate in pediatric patients with severe arrhythmias.
- To assess both intravenous and oral administration routes for flecainide acetate.
Main Methods:
- A cohort of 12 children (aged 1-15 years) with severe arrhythmias received flecainide acetate.
- Treatment involved initial intravenous administration followed by oral therapy.
- Patients presented with various arrhythmias including Wolff-Parkinson-White syndrome, concealed accessory pathways, His bundle tachycardia, and ventricular tachycardia.
Main Results:
- Intravenous flecainide acetate successfully restored sinus rhythm in 4 out of 7 patients and achieved rate control in another.
- Oral flecainide acetate prevented arrhythmia recurrence in 9 out of 12 patients and provided satisfactory rate control in one.
- Two patients discontinued oral flecainide acetate due to increased tachycardia frequency; no other adverse effects were reported.
Conclusions:
- Flecainide acetate demonstrates significant efficacy in managing complex pediatric arrhythmias.
- The drug exhibits a favorable safety profile with low toxicity in the pediatric population.
- Flecainide acetate may be a valuable therapeutic option for selected children with refractory arrhythmias.
Abstract:
Flecainide acetate was administered intravenously and orally to 12 consecutive children, aged 1-15 years, presenting with arrhythmias that were life threatening or resistant to conventional medical treatment. Three children had arrhythmias related to Wolff-Parkinson-White syndrome, four had concealed accessory pathways, two had His bundle tachycardia, and three had ventricular tachycardia. Of seven patients who were given flecainide intravenously, four returned to sinus rhythm and in a fifth successful rate control of His bundle tachycardia was achieved. All 12 patients were given the drug orally: in nine it was successful in preventing recurrence of arrhythmia, in one satisfactory rate control was achieved, and in two it was withdrawn because it produced more frequent attacks of tachycardia. No other adverse effects occurred. The efficacy and low toxicity of treatment in this study suggests that flecainide acetate may have an important role in the management of selected paediatric arrhythmias.