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Ivabradine Use in Premature Infants With Accelerated Idioventricular Rhythm
Nawin L Ramdat Misier1,2, Pezad N Doctor1, Kaitlin Tindel3
1Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Ivabradine effectively treated accelerated idioventricular rhythm (AIVR) in two preterm infants when other antiarrhythmic drugs failed. This suggests ivabradine is a promising treatment for AIVR in premature neonates.
Area of Science:
- Pediatric Cardiology
- Neonatal Medicine
- Pharmacology
Background:
- Ivabradine is approved for pediatric focal atrial and junctional ectopic tachycardias.
- Limited data exists on ivabradine for ventricular tachyarrhythmias in neonates, specifically accelerated idioventricular rhythm (AIVR).
Observation:
- Two preterm infants with AIVR, unresponsive to other antiarrhythmic therapies, were treated with ivabradine monotherapy.
- The infants had different cardiac anatomies: one with a structurally normal heart, the other with truncus arteriosus.
Findings:
- Ivabradine successfully restored sinus rhythm in both infants.
- The only observed side effects were transient, hemodynamically insignificant bradycardia episodes.
Implications:
- Ivabradine shows promise as an antiarrhythmic agent for AIVR in preterm infants.
- Its hemodynamic stability makes it a valuable option for AIVR management, particularly postoperatively.
- Further investigation into ivabradine's safety, optimal dosage, and mechanism in neonates with AIVR is necessary.
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