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Digoxin or flecainide for prophylaxis of supraventricular tachycardia in infants?

J J O'Sullivan1, H M Gardiner, C Wren

  • 1Department of Paediatric Cardiology, Freeman Hospital, Newcastle upon Tyne, England, United Kingdom.

Journal of the American College of Cardiology
|October 1, 1995
PubMed

Insights

Digoxin showed limited effectiveness for preventing supraventricular tachycardia in infants. Oral flecainide proved highly effective and safe for prophylaxis, suggesting it may be a preferred treatment option.

Area of Science:

  • Pediatric Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Supraventricular tachycardia (SVT) recurrence is common in infants.
  • Digoxin is the standard first-line prophylaxis, but its efficacy lacks controlled trial data.
  • Optimal treatment for digoxin-resistant SVT in infants is not established.

Purpose of the Study:

  • To compare the safety and efficacy of digoxin versus flecainide for SVT prophylaxis in infants.
  • To evaluate flecainide as an alternative prophylactic agent when digoxin is ineffective.

Main Methods:

  • Retrospective review of infant SVT cases (atrioventricular reentry) from 1986-1993.
  • Analysis of treatment outcomes for infants receiving oral digoxin or oral flecainide.
  • Assessment of tachycardia recurrence and adverse events.

Main Results:

  • Digoxin prophylaxis failed in 58% of infants, necessitating a switch to flecainide.
  • Oral flecainide achieved 96% efficacy in preventing SVT recurrence.
  • No adverse effects were reported with flecainide treatment.

Conclusions:

  • Digoxin appears ineffective for SVT prophylaxis in infants.
  • Oral flecainide demonstrates high efficacy and safety for infant SVT prophylaxis.
  • Flecainide may be a preferred primary prophylactic agent for infant SVT.
Abstract

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