Early experience with intravenous sotalol in children with and without congenital heart disease

Santiago O. Valdés, Christina Y. Miyake, Mary C. Niu, Caridad M. de la Uz, S. Yukiko Asaki, Andrew P. Landstrom, Andrew E. Schneider, Craig G. Rusin, Raajen Patel, Wilson W. Lam, Jeffrey J. Kim

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background: Arrhythmias are common in the pediatric population. In patients unable to take oral medications or in need of acute therapy, options of intravenous (IV) antiarrhythmic medications are limited. Recently IV sotalol has become readily available, but experience in children is limited. Objective: The purpose of this study was to describe our initial experience with the use of IV sotalol in the pediatric population. Methods: A retrospective study of all pediatric patients receiving IV sotalol was performed. Patient demographic characteristics, presence of congenital heart disease, arrhythmia type, efficacy of IV sotalol use, and adverse effects were evaluated. Results: A total of 47 patients (26 (55%) male and 24 (51%) with congenital heart disease) received IV sotalol at a median age of 2.05 years (interquartile range 0.07–10.03 years) and a median weight of 12.8 kg (interquartile range 3.8–34.2 kg), and 13 (28%) received IV sotalol in the acute postoperative setting. Supraventricular arrhythmias occurred in 40 patients (85%) and ventricular tachycardia in 7 (15%). Among 24 patients receiving IV sotalol for an active arrhythmia, acute termination was achieved in 21 (88%). Twenty-three patients received IV sotalol as maintenance therapy for recurrent arrhythmias owing to inability to take oral antiarrhythmic medications; 19 (83%) were controlled with sotalol monotherapy. No patient required discontinuation of IV sotalol secondary to adverse effects, proarrhythmia, or QT prolongation. Conclusion: IV sotalol is an effective antiarrhythmic option for pediatric patients and may be an excellent agent for acute termination of active arrhythmias. It was well tolerated, with no patient requiring discontinuation secondary to adverse effects.

Original languageEnglish (US)
Pages (from-to)1862-1869
Number of pages8
JournalHeart Rhythm
Volume15
Issue number12
DOIs
StatePublished - Dec 2018
Externally publishedYes

Keywords

  • Arrhythmia
  • Intravenous sotalol
  • Pediatrics
  • Sotalol
  • Supraventricular arrhythmia
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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