Prediction of antiarrhythmic therapy effectiveness in children

Svintsova, L. I.; Джаффарова, О. Ю.; Плотникова, И. В.

doi:10.15829/1560-4071-2019-7-75-82

Cited by 3 publications

(2 citation statements)

References 23 publications

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“…Нельзя исключить, что это связано с более хорошим прогнозом в отношении различных НРС у детей раннего возраста, у которых при дальнейшем формировании структуры сердца, в т.ч. проводящей системы сердца, часто происходит спонтанное исчезновение аритмии [3,14]. Чем старше ребенок, тем устойчивее аритмия и ниже эффективность ААТ [14].…”

Section: материал и методыunclassified

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Effectiveness of beta-blockers in the treatment of idiopathic premature ventricular contractions in children

et al. 2022

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Aim. To evaluate the effectiveness of beta-blockers (BB) in the treatment of idiopathic premature ventricular contractions (PVCs) in children.Material and methods. BBs were prescribed to 27 children with idiopathic PVCs. In 3 (11,1%) patients, side effects (hypotension, bronchial obstruction) was revealed at the beginning of therapy. A total of 24 children were included in the further study (15 boys (62,5%), 9 girls (37,5%). The mean age was 8,3±5,4 years. Data from anamnesis, electrocardiography (ECG), 24-hour ECG monitoring, and echocardiography were analyzed.Results. The 24-hour PVC rate was 33,2±17,7 thousand/day or 26,6±13,2%. In 14 (58,3%) children, we recorded paired PVCs, in 3 (12,5%) — multiform, in 10 (41,7%) — runs of non-sustained VT. There were complaints in 7 (29,2%) children. The follow-up period lasted 369,8±119,1 days. Propranolol was received by 17 (70,8%) patients, metoprolol — by 7 (29,2%). The therapy was effective in 11 (45,8%) patients, while ineffective in 13 (54,2%), among which 5 (20,8%) had an increase in the number of PVCs. The effectiveness of BBs was higher in children under the age of 1 year (p=0,043). Propranolol showed greater efficacy than metoprolol (p=0,047). Less efficiency was observed in female patients and those with pathological heart rate turbulence parameters (p=0,04).Conclusion. The effectiveness of BBs in children with idiopathic PVCs is 45,8%, higher in children aged <1 year and declines with age, decreasing in adolescents to 25%. The use of BBs is limited by non-cardiac side effects in 11,1% of children. Propranolol is more effective than metoprolol.

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Section: материал и методыunclassified

“…проводящей системы сердца, часто происходит спонтанное исчезновение аритмии [3,14]. Чем старше ребенок, тем устойчивее аритмия и ниже эффективность ААТ [14].…”

Section: материал и методыunclassified

Effectiveness of beta-blockers in the treatment of idiopathic premature ventricular contractions in children

et al. 2022

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Efficacy of Propafenone for Treating Idiopathic Premature Ventricular Contractions in Children

Alekseeva,

Kruchina,

Maljarova

et al. 2024

Annals RAMS

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Background. Premature ventricular contractions (PVCs) are a common heart rhythm disorder in children, often following a benign course. However, in rare cases, antiarrhythmic therapy is required for managing this arrhythmia. Limited data is available regarding the effectiveness of such therapy specifically in children. Objective. To evaluate the efficacy and safety of propafenone administration in children with idiopathic PVCs. Methods. The study enrolled 33 children aged 11.1 ± 4.8 years (29 days — 17 years) with idiopathic PVCs. Propafenone dose was titrated from initial (5–7 mg/kg/day) to effective (no more than 15 mg/kg/day) dose under clinical and electrocardiographic control to monitor for proarrhythmias and other side effects. An increase in PQ interval duration and a widening of the QRS complex no more than 25% compared to baseline was considered acceptable. Results. The incidence of PVCs before propafenone administration was 36.3 ± 10.1 (22.0–60.6) thousands/day or 33.2 ± 8.4% (20.5–50.0). Complex forms of PVCs were observed in 25 (75.8%) children: 25 (75.8%) had frequent paired PVCs, 6 (18.2%) had polymorphic PVCs, 20 (60.6%) had short runs of ventricular tachycardia (VT), and 19 (27.6%) had a combination of various forms of PVCs. The starting dose of propafenone was 5.6 ± 2.2 mg/kg/day with subsequent increases to 10 ± 0.8 mg/kg/day. Propafenone was employed as the initial therapy in 23 (69.7%) children and as a second line therapy in 10 (30.3%) children, following the ineffectiveness or adverse effects of beta-adrenoblockers. The duration of propafenone therapy was 95.8 ± 62.8 days. Propafenone was effective in 25 (75.8%) children. The average reduction in the number of PVCs during therapy was 71.7 ± 32.6% (13.0–100.0) during therapy. One (3%) child developed proarrhythmia — sustained VT and 1 (3%) child had gastrointestinal side effects. Conclusion. Propafenone is an effective antiarrhythmic drug in children with idiopathic PVCs, including patients with poor response to beta-adrenoblockers. Arrhythmogenic and extracardiac side effects are possible during propafenone therapy, which require clinical and electrocardiographic observation in the process of selecting an effective dose of the drug.

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Prognostic factors for the effectiveness of catheter ablation of focal atrial tachycardia in school-age children: data from a single-center registry study

Kovalchuk,

Tatarsky,

Alekseeva

et al. 2024

Vestnik aritmologii

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Aim. To identify factors associated with the effectiveness of radiofrequency catheter ablation (RFA) of focal atrial tachycardia (AT) in school-aged patients in the long-term period.Methods. The study group consisted of 57 children aged 11 to 17 years 11 months (Me 15.83, IQR 14.63-17.0), who underwent catheter ablation, including repeated, for focal AT in the Almazov National Medical Research Centre from December 2009 until April 2023. We analyzed clinical and demographic data, laboratory data, parameters of tachyarrhythmia, electrophysiological study and RFA. Structural heart diseases were present in 13 children, and idiopathic arrhythmia was present in 44 patients. The criterion for intraoperative effectiveness were the absence of arrhythmia at the end of the waiting period in the X-ray operating room, delayed - within 12 months after the procedure.Results. Intraoperative effectiveness of RFA was achieved in 51 patients (89.5%), long-term - in 32 patients (56.1%). Based on the data obtained, a prognostic model of the delayed effectiveness of RFA of focal AT in school-age children was developed (p<0.001). Predictors included in the model: percentage of arrhythmia during the day (odds ratio (OR): 0.981; 95% confidence interval (CI) 0.962-0.999; p=0.043), presyncope (OR: 0.177; 95% CI 0.035-0.903; p=0.037), number of ectopic foci (OR: 0.289; 95% CI 0.128-0.649; p=0.003), right atrium localization (OR: 0.097; 95% 0.013-0.699; p=0.021). The area under the ROC curve corresponding to the association of the absence of arrhythmia after ablation and the values of the logistic regression function was 0.843±0.54 with 95% CI: 0.738-0.938. The sensitivity was 81.3%, specificity - 76.0%. No significant association with effectiveness of RFA was found between the method of arrhythmia induction and the use of drug sedation.Conclusion. It was established that factors such as percentage of arrhythmia during the day, the presence of presyncope, the number of ectopic foci and the presence of an ectopic foci in the right atrium had an inverse relationship with the effective outcome of RFA.

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Prediction of antiarrhythmic therapy effectiveness in children

Cited by 3 publications

References 23 publications

Effectiveness of beta-blockers in the treatment of idiopathic premature ventricular contractions in children

Effectiveness of beta-blockers in the treatment of idiopathic premature ventricular contractions in children

Efficacy of Propafenone for Treating Idiopathic Premature Ventricular Contractions in Children

Prognostic factors for the effectiveness of catheter ablation of focal atrial tachycardia in school-age children: data from a single-center registry study

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