M. Sasse et al., SOTALOL ASSOCIATED TORSADES-DE-POINTES TACHYCARDIA IN A 15-MONTH-OLD CHILD - SUCCESSFUL THERAPY WITH MAGNESIUM ASPARTATE, PACE, 21(5), 1998, pp. 1164-1166
Torsades de pointes (Tdp) is a form of ventricular tachycardia, and it
s occurrence in childhood is very rare. In adult patients treated with
sotalol, Tdp has been reported to the occur with an incidence of 2%-4
%. In children who are treated with sotalol, occurrence of Tdp has bee
n reported in only a single case. A 15-month-old girl with Wolff-Parki
nson-White syndrome developed recurrent syncopal attacks. She had been
treated with sotalol 1.5 mg/kg daily since shortly after birth becaus
e of recurrent episodes of paroxysmal supraventricular tachycardia. EC
G monitoring exhibited frequent Tdp tachycardia. Serum electrolyte lev
els were normal. Echocardiographic analysis excluded a structural hear
t defect and did not show any signs of myocardial infection. Sotalol t
reatment was stopped and an infusion with lidocaine was started. Despi
te this therapy the Tdp continued. Magnesium aspartate rr as then admi
nistered, which immediately stopped the Tdp. As no other reason was ev
ident, Tdp in this child has to be judged as a proarrhythmia related t
o sotalol therapy.