SOTALOL ASSOCIATED TORSADE-DE-POINTES TAC HYCARDIA IN A 15-MONTH-OLD CHILD

Torsade de pointes (tdp) is a form of ventricular tachycardia whose oc currence in childhood is very rare. In adults treated with sotalol (So talex(R)), tdp has been reported to have an incidence of 2-4%. There h ave been no reports of its occurrence in children treated with sotalol . We report about a 15-month-old girl with Wolff-Parkinson-White syndr ome who developed recurrent syncopal attacks. She had been treated wit h sotalol at 1.5 mg/kg daily since being a newborn because of recurren t episodes of paroxysmal supraventricular tachycardia. Electrocardiogr am exhibited frequent tdp tachycardia. Serum electrolyte levels were n ormal. Echocardiography excluded a structural heart defect and showed no signs of myocardial infection. After sotalol was ceased, infusion w ith lidocain was started. Despite this therapy the tdp continued. Magn esium aspartate (Magnesiocard) was then administered, and this finally stopped the tdp. As no other cause was evident, tdp in this child mus t be judged as a proarrhythmia related to sotalol therapy.