LONG-TERM EFFICACY AND SAFETY OF ATENOLOL FOR SUPRAVENTRICULAR TACHYCARDIA IN CHILDREN

Propranolol, a first-generation nonselective beta-adrenoceptor blockin g agent, is commonly used to treat pediatric arrhythmias. Atenolol, re latively long-acting, cardioselective beta-adrenoceptor blocking agent , has been successfully used in adults with supraventricular tachycard ia (SVT). There is only one report on the use of atenolol in children with SVT, and our report is on the first long-term prospective study t o evaluate the use of atenolol in children. A group of 22 children <18 years of age with clinical SVT were enrolled in the study. The tachyc ardia was documented on electrocardiograms in each case and was confir med by electrophysiologic studies in some. Once-a-day oral atenolol wa s started as a monotherapy. Of the 22 children with various types of S VT, 13 (59%) were well controlled on long-term oral atenolol therapy. The effective dose of atenolol ranged between 0.3 and 1.3 mg/kg/day (m edian effective dose 0.7 mg/kg/day). Five children had some adverse ef fects. However, none in the successful group of 13 patients required d rug discontinuation because of such effects. Once-a-day oral atenolol as a monotherapy is effective and relatively safe for long-term manage ment of SVT during childhood. It is an attractive alternative beta-adr enoceptor blocking agent for the management of pediatric arrhythmias.