ATENOLOL IN THE PROPHYLAXIS OF RECURRENT SUPRAVENTRICULAR TACHYCARDIAIN CHILDREN

Background Supraventricular reentrant tachycardias are the most common cardiac arrhythmia observed in infancy and childhood. The often benig n clinical course of the disease warrants careful selection of any ant iarrhythmic drug given to prevent recurrencies, in order to avoid pote ntially dangerous side-effects such as proarrhythmia. This study repor ts our experience with atenolol in the longterm treatment of infants a nd children with supraventricular tachycardias. Patients and methods a search of our database was made and all the children admitted in our institution between 1987 and 1995 for treatment of supraventricular ta chycardia were selected. Patients who had longterm oral treatment with atenolol were retrospectively evaluated and were seen during 1996 in our outpatient clinic for a follow-up examination including a Holter-m onitor. Results 14 infants and children with a median age of 2 9/12,, years at first presentation could be evaluated. In 10 patients, atenol ol was the first antiarrhythmic drug given. In 10 of the patients (72% ) therapy with atenolol was considered successful and no further attac ks of tachycardia occurred. In 2 patients a partial response to atenol ol was seen with an important decrease in the frequency of tachycardia s. Two patients showed no effect of treatment and the betablocker was withdrawn. The effect of the drug on heart rate and blood pressure was mild and did not lead to symptoms. In no case had the drug to be with drawn for adverse effects. After a mean follow-up of 50 months (3-105 months), 7 patients were off the drug and free of recurrencies while a mong the 5 children still on atenolol, only one experienced rare episo des of tachycardia. Conclusion Atenolol is efficient in the longterm t reatment of supraventricular tachycardias and due to its favorable ris k profile can be recommended as first line treatment option.