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Effect of methadone on QTc in infants
Katelyn Snyder1, Scott Maurer1, Melissa Riley1
1Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, United States of America.
Insights
Methadone treatment in infants did not significantly prolong the QTc interval. This study found no significant QTc prolongation in infants receiving methadone, suggesting careful monitoring may be beneficial.
Area of Science:
- Pediatric Cardiology
- Neonatal Pharmacology
- Clinical Electrophysiology
Background:
- Methadone is known to prolong the QTc interval on electrocardiograms (ECG).
- The effects of methadone on QTc interval in infants are not well-documented.
- This study addresses the lack of data on methadone's impact on infant QTc.
Purpose of the Study:
- To evaluate the QTc interval in infants undergoing methadone treatment.
- To determine if methadone therapy causes significant QTc prolongation in this population.
Main Methods:
- Retrospective study of 44 infants receiving methadone.
- Collected demographic data, methadone dose, and QTc measurements.
- QTc values were determined by a blinded pediatric electrophysiologist, comparing baseline ECGs to those during methadone therapy.
Main Results:
- The mean baseline QTc was 421 ± 27 ms, with a mean change of -2 ms on methadone.
- No infants exhibited QTc prolongation above 500 ms.
- One infant had a QTc of 467 ms with a 46 ms increase from baseline, deemed not clinically significant.
Conclusions:
- Methadone did not significantly prolong the QTc interval in the studied infant population.
- Further prospective research is recommended to establish the need and frequency of ECG monitoring for infants on methadone.
Objective:
Methadone has been associated with prolongation of the QTc interval (QTc) on electrocardiogram (ECG). In infants, the effects of methadone on the QTc are not well described. Our study's objective is to evaluate the QTc in infants being treated with methadone.
Methods:
We conducted a retrospective study in infants receiving methadone. We collected demographic data, methadone dose, and QTc. A blinded-to-disease-state pediatric electrophysiologist determined the QTc. Baseline ECG was defined as an ECG obtained while not on methadone therapy, and QTc on baseline ECG was compared with treatment QTc. A significant change was defined as any absolute QTc greater than 500 or a QTc greater than 460 with an increase from baseline of greater than 40 ms.
Results:
A total of 44 infants comprised the study population. The mean gestational age was 32.3 ± 5.51 weeks. The median age of initiation was 66 days. The median dose was 0.52 mg/kg/day in oral methadone equivalents. Nine patients were on high dose methadone (>1 mg/kg/day in oral methadone equivalents). The mean baseline QTc was 421 ± 27 and the mean change on methadone was -2 ms. No patient had a QTc greater than 500 on methadone. One patient had a QTc of 467 and 46 ms change from baseline, with no clinically significant impact.
Conclusion:
In our study population, methadone did not significantly prolong the QTc. Further prospective study is warranted to determine the utility and frequency of ECGs in infants receiving methadone.
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