RESULTS OF A RESTRICTIVE USE OF ANTIARRHYTHMIC DRUGS IN THE CHRONIC TREATMENT OF ATRIOVENTRICULAR REENTRANT TACHYCARDIAS IN INFANCY AND CHILDHOOD

Childhood supraventricular tachycardia (SVT) carries a good prognosis. Thus, treatment should be based on the use of drugs with a low risk o f such potentially serious side effects as proarrhythmia, which is wel l documented for class I and III drugs in children, We studied all ped iatric patients with a first manifestation of SVT between 1988 and the end of 1995 who were seen for a follow-up examination, including Holt er monitoring, during 1996, The minimum follow-up period was 12 months . Fifty children met study entry criteria. Mean patient age at first p resentation was 2 years (median 1 month), with 33 of the patients (66% ) having experienced their first episode of tachycardia in their first year of life. Of 39 patients initially treated with either digoxin or a beta blocker, SVT in 29 (75%) responded favorably to this treatment , There were no adverse effects. Of the 10 children whose disease did not respond to these first-line agents, 9 (23% of those treated) requi red class I or III antiarrhythmic drugs. Thus, first-line antiarrhythm ic long-term prophylaxis using drugs with a favorable risk profile, su ch as digoxin and beta blockers, resulted in successful disease manage ment in a large proportion of unselected children, avoiding the need f or chronic use of class I or class Ill antiarrhythmic drugs. (C) 1998 by Excerpta Medica, Inc.