EXPERIENCES WITH IPRATROPIUMBROMID IN THE THERAPY OF BRADYARRHYTHMIASIN CHILDHOOD

Ipratropiumbromid is used in adults for a variety of bradyarrhythmias. In contrast this therapy has not yet been established in childhood, w here symptomatic bradycardias are less frequent. Since Ipratropiumbrom id has less side effects (especially concerning the central nervous sy stem) apd a longer half time than atropin, we investigated the efficac y of Ipratropiumbromid in 12 children (mean age 7.2 yrs.) in the cours e of 2 1/2 years. We found a significant increase of the minimal and m ean heart rate in Holter-Ecg-recordings. Only in 7 of 12 patients we o btained a sufficiant therapeutic effect. In one patient we had to term inate the therapy because of side effects. In two patients with atriov entricular block and two children with higher degree sinus node dysfun ction could be removed only by implantation of a pacemaker.In another case we observed the proarrhythmical effect of Ipratropiumbromid. Summ arizing we think, that the therapy with Ipratropiumbromid may be usefu l in symptomatical supranodal bradyarrhythmias in childhood in regard of sideeffects.