Related Experiment Video
Updated: Dec 23, 2025
Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
Published on: September 24, 2021
Intravenous Sotalol in the Young: Safe and Effective Treatment With Standardized Protocols
Alejandro A Borquez1, Othman A Aljohani1, Matthew R Williams1
1Division of Pediatric Cardiology, Department of Pediatrics, University of California-San Diego School of Medicine, Rady Children's Hospital, San Diego, California, USA.
Insights
Intravenous (IV) sotalol is a safe and effective treatment for pediatric arrhythmias. A standardized protocol for rapid infusion demonstrated successful acute therapy and maintenance dosing in young patients.
Area of Science:
- Pediatric Cardiology
- Clinical Pharmacology
- Cardiac Electrophysiology
Background:
- Acute arrhythmia management in pediatric patients presents limited treatment options.
- Intravenous (IV) sotalol is an emerging therapeutic choice, yet its pediatric application and standardized protocols for acute administration are not well-established.
- This study addresses the need for evidence-based guidelines by evaluating a single center's experience with IV sotalol in pediatric patients.
Purpose of the Study:
- To assess the safety and efficacy of novel, standardized protocols for IV sotalol administration in pediatric patients.
- To describe a protocol for rapid IV sotalol infusion for acute pediatric arrhythmias.
- To evaluate the safety and efficacy of IV sotalol for maintenance therapy in pediatric patients.
Main Methods:
- A retrospective study was conducted at Rady Children's Hospital, analyzing data from 37 pediatric patients who received IV sotalol between December 2015 and December 2018.
- Patients were categorized into two groups: acute therapy (n=26) and maintenance therapy (n=11).
- Data collected included demographics, arrhythmia type, hemodynamic parameters, and the effects of IV sotalol treatment.
Main Results:
- Thirty-seven pediatric patients received IV sotalol. In the acute therapy group (n=26), which included patients with atrial flutter, supraventricular tachycardia (SVT), and atrial ectopic tachycardia (AET), a median dose of 30 mg/m² administered over 15 minutes resulted in successful cardioversion in all SVT patients (100%).
- The maintenance therapy group (n=11) received a median dose of 54 mg/m²/day over 120 minutes, with all patients maintaining sinus rhythm.
- No adverse events requiring cessation of IV sotalol were reported.
Conclusions:
- Intravenous sotalol is a safe and effective therapeutic option for both acute and maintenance management of arrhythmias in pediatric patients.
- A rapid infusion protocol of 30 mg/m² over 15 minutes proved effective for acute cardioversion in pediatric patients.
- The findings support the integration of IV sotalol into the therapeutic armamentarium for pediatric cardiac arrhythmias.
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.
More Related Videos
05:36Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
06:57Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
Published on: January 31, 2019
Related Concept Videos
01:25Dysrhythmias VI: Management of Dysrhythmias
01:22Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
01:29Drug Dosing: Infants and Children
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:12Antiarrhythmic Drugs: Class III Agents as Potassium Channel Blockers
01:25Dysrhythmias VII: Nursing Management of Dysrhythmias