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[Propafenon therapy of arrhythmias in infancy and childhood (author's transl)]
Insights
This study determined propafenone dosage for pediatric cardiac arrhythmias. Effective intravenous and oral doses were established, with most patients showing arrhythmia reduction or elimination and minimal side effects.
Area of Science:
- Pediatric Cardiology
- Clinical Pharmacology
Background:
- Cardiac arrhythmias are common in infants and children.
- Propafenone is an antiarrhythmic drug with established use in adults, but its pediatric dosing requires further study.
Purpose of the Study:
- To determine the therapeutic dose range of propafenone in pediatric patients with various cardiac arrhythmias.
- To establish effective intravenous and oral dosing regimens for propafenone in children.
Main Methods:
- A study involving 28 infants and children with cardiac arrhythmias.
- Administration of intravenous and oral propafenone at varying dosages based on body weight.
- Monitoring of arrhythmia control and serum drug levels.
Main Results:
- Intravenous propafenone effectively abolished arrhythmias at doses of 0.71-3.2 mg/kg/d.
- Oral maintenance doses of 3.6-13.3 mg/kg/d achieved therapeutic serum levels (>150 ng/ml).
- Arrhythmias were resolved in 20 patients, reduced in 7, with one failure; transient elevated gamma-GT was the only side effect.
Conclusions:
- Propafenone is effective and safe for treating cardiac arrhythmias in pediatric patients.
- Established intravenous and oral dosing regimens facilitate therapeutic drug levels and clinical improvement.
Abstract:
The therapeutic dose range of propafenon was studied in 28 infants and children aged 5 days to 15.2 years (mean 8.8 years) with the following cardiac arrhythmias: paroxysmal tachycardia (20) atrial flutter (5) ventricular extrasystoles (2) and junctional tachycardia (1). With the intravenous administration of the drug in a dosage of 1.03-3.2 mg/kg/d (mean 2.28 mg/kg/d) in patients less than 15 kg and of 0.71-2.06 mg/kg/d (mean 1.26 mg/kg/d) in patients more than 15 kg body weight arrhythmias abolished. In the same patients the oral dosage was 12.2-22.6 mg/kg/d (mean 16.03 mg/kg/d) and 7.2-16.6 (mean 11.12 mg/kg/d). After 10 to 14 days a therapeutic serum level above 150 ng/ml could be maintained by a reduced oral dosage of 5.7-13.3 mg/kg/d) mean 8.5 mg/kg/d) and 3.6-11.1 mg/kg/d (mean 6.33 mg/kg/d) respectively. There were no side effects except for transitory by elevated gamma-GT in 8 patients. During a follow-up period of 1 month to 2.2 years (mean 1.6 years) 20 patients had no more arrhythmias, in 7 the number of arrhythmic attacks was reduced, and in 1 therapy failed.