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Sotalol prophylaxis was efficient and safe for supraventricular tachycardia in early infancy

Caroline Evertsson1, Håkan Eliasson2,3, Cecilia Pegelow Halvorsen1,4

  • 1Sachs' Children and Youth Hospital, Stockholm South General Hospital (Södersjukhuset), Stockholm, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|July 29, 2024
PubMed

Insights

Sotalol is an effective and safe prophylaxis for infant supraventricular tachycardia (SVT). This study found high success rates with minimal QTc prolongation and no proarrhythmia, supporting its use in pediatric cardiology.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Supraventricular tachycardia (SVT) in infancy lacks a consensus on optimal prophylactic treatment.
  • Sotalol is a beta-blocker and class III antiarrhythmic agent with potential for SVT prophylaxis.

Purpose of the Study:

  • To evaluate the efficacy and safety of sotalol as a prophylactic agent for SVT in infants.
  • To assess treatment outcomes, including success rates and adverse events like QTc prolongation and proarrhythmia.

Main Methods:

  • Retrospective analysis of 85 infants diagnosed with SVT before one year of age treated with sotalol (2002-2018).
  • Data collected included patient characteristics, comorbidities, sotalol dosage, QT intervals, and clinical outcomes.
  • Statistical analysis compared success rates between infants with postnatal versus fetal debut.

Main Results:

  • Sotalol demonstrated high efficacy, with successful prophylaxis in 67/75 patients completing treatment, including those with re-entry tachycardia.
  • Infants with postnatal debut showed significantly higher success rates (96%) compared to those with fetal debut (78%).
  • QTc interval prolongation occurred in 16% of patients, with only two requiring treatment change; no proarrhythmia was observed.

Conclusions:

  • Sotalol is an effective and safe prophylactic treatment for SVT in the infant population.
  • QTc prolongation is a rare side effect that seldom necessitates treatment discontinuation, and proarrhythmia is not a significant concern.
Abstract

Keywords:
Wolff‐Parkinson‐White syndromearrhythmia prophylaxissotalolsupraventricular tachycardiatreatment efficacy

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