Cardiovascular Collapse with Intravenous Amiodarone in Children: A Multi-Center Retrospective Cohort Study

Maghrabi, Khadijah; Uzun, Orhan; Kirsh, Joel A.; Balaji, Seshadri; Bergen, Nicholas H. Von; Sanatani, Shubhayan

doi:10.1007/s00246-019-02090-7

Cited by 17 publications

(10 citation statements)

References 30 publications

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“…However, if the tachycardia does not resolve with medical treatment, catheter ablation procedures may be required as an alternative option. 2,4,6,13,14 In this specific case, although tachycardia was resolved completely on the sixth day of life without further need of the catheter ablation procedure in the patient, he then died due to septic shock. Intravenous adenosine is recommended as the first choice of treatment to terminate hemodynamically stable acute episodes of re-entrant SVT involving AV node.…”

Section: Discussionmentioning

confidence: 72%

“…It was concluded that intravenous amiodarone may cause sinus bradycardia, AV block, hypotension, and cardiovascular collapse that mostly occur within the first 90 minutes of intravenous amiodarone infusion. 14 It was also noted that esmolol (0.5 mg/kg rapid intravenous bolus followed by 50-200 µg/kg/min) can be used for the termination of neonatal SVT. 12 Rare side effects including bradycardia, decompensated heart failure, asystolic cardiac arrest, and heart block may be caused by esmolol administration.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Permanent Junctional Reciprocating Tachycardia in a Preterm Neonate: Case Report

İlhan

Hakan

Kayılıoğlu

et al. 2020

J Pediatr Intensive Care

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Permanent junctional reciprocating tachycardia (PJRT) is most often observed in infants and children and can lead to incessant tachycardia. PJRT is usually refractory to medical treatment. Tachycardia may infrequently occur in the fetus in which case fetal tachycardia transplacental treatment should be started immediately. Term delivery is recommended for fetuses with tachycardia in the absence of significant clinical compromise to avoid complications of preterm birth. Herein, a 36-week preterm neonate presented with PJRT. He had tachycardia in the fetal period and was treated with digoxin, amiodaron, and esmolol therapy after birth without undergoing the catheter ablation procedure.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Treatment of Permanent Junctional Reciprocating Tachycardia in a Preterm Neonate: Case Report

İlhan

Hakan

Kayılıoğlu

et al. 2020

J Pediatr Intensive Care

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“…This is unlike the data recently reported with IV amiodarone administration and the risk of developing cardiovascular collapse in a significant subset of children, especially in young infants, patients with hemodynamic compromise, and patients receiving rapid amiodarone bolus administration. 17 Although this study did not specifically look at IV amiodarone versus IV sotalol, it suggests a need to reconsider the perceived advantage and safety of amiodarone and consider an expanded role of IV sotalol in pediatric arrhythmia management.…”

Section: Discussionmentioning

confidence: 95%

IV Sotalol Use in Pediatric and Congenital Heart Patients: A Multicenter Registry Study

Malloy-Walton

Bergen

Balaji

et al. 2022

JAHA

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Background There is limited information regarding the clinical use and effectiveness of IV sotalol in pediatric patients and patients with congenital heart disease, including those with severe myocardial dysfunction. A multicenter registry study was designed to evaluate the safety, efficacy, and dosing of IV sotalol. Methods and Results A total of 85 patients (age 1 day–36 years) received IV sotalol, of whom 45 (53%) had additional congenital cardiac diagnoses and 4 (5%) were greater than 18 years of age. In 79 patients (93%), IV sotalol was used to treat supraventricular tachycardia and 4 (5%) received it to treat ventricular arrhythmias. Severely decreased cardiac function by echocardiography was seen before IV sotalol in 7 (9%). The average dose was 1 mg/kg (range 0.5–1.8 mg/kg/dose) over a median of 60 minutes (range 30–300 minutes). Successful arrhythmia termination occurred in 31 patients (49%, 95% CI [37%–62%]) with improvement in rhythm control defined as rate reduction permitting overdrive pacing in an additional 18 patients (30%, 95% CI [19%–41%]). Eleven patients (16%) had significant QTc prolongation to >465 milliseconds after the infusion, with 3 (4%) to >500 milliseconds. There were 2 patients (2%) for whom the infusion was terminated early. Conclusions IV sotalol was safe and effective for termination or improvement of tachyarrhythmias in 79% of pediatric patients and patients with congenital heart disease, including those with severely depressed cardiac function. The most common dose, for both acute and maintenance dosing, was 1 mg/kg over ~60 minutes with rare serious complications.

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“…This might have avoided unnecessary cardioversion and initiation of antiarrhythmic drugs with unstable hemodynamic profile and this was especially evident in the second case. [ 16 18 ] A recent report showed that enteral ivabradine was effective in an infant with multifocal atrial tachycardia with severe ventricular dysfunction requiring mechanical support. [ 7 ] Thus, early initiation of ivabradine in automatic tachyarrhythmias with severe LV dysfunction and unstable hemodynamics may avoid unnecessary cardioversion, invasive procedures, and initiation of antiarrhythmic drugs with unstable hemodynamic profile.…”

Section: Discussionmentioning

confidence: 99%

Tachycardia-induced cardiomyopathy secondary to incessant ectopic atrial tachycardia in two infants

Karmegaraj

Balaji

Raju

et al. 2021

Annals of Pediatric Cardiology

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This report describes two cases of tachycardia-induced cardiomyopathy secondary to incessant ectopic atrial tachycardia (EAT) in an infant presenting with severe left ventricular dysfunction and hemodynamic instability. The two cases were managed differently. The first required mechanical ventilation and was resistant to conventional antiarrhythmic drugs. After the initiation of enteral ivabradine (0.15mg/kg) the heart rate slowed with significant improvement in hemodynamics, peripheral perfusion and sinus rhythm was restored after 12 hours. Ivabradine was continued and the patient was discharged home after 10 days of hospitalization. The second case was managed by early initiation of ivabradine and resulted in restoration of sinus rhythm within 4 hours, thus avoiding trials of conventional anti-arrhythmic drugs with unstable hemodynamic profile. The infant was discharged after 5 days of hospitalization on ivabradine..

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Cardiovascular Collapse with Intravenous Amiodarone in Children: A Multi-Center Retrospective Cohort Study

Cited by 17 publications

References 30 publications

Treatment of Permanent Junctional Reciprocating Tachycardia in a Preterm Neonate: Case Report

Treatment of Permanent Junctional Reciprocating Tachycardia in a Preterm Neonate: Case Report

IV Sotalol Use in Pediatric and Congenital Heart Patients: A Multicenter Registry Study

Tachycardia-induced cardiomyopathy secondary to incessant ectopic atrial tachycardia in two infants

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