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Electrophysiological effects and clinical utility of propafenone in children

Part of: Cardiac Morphology

Published online by Cambridge University Press:  29 July 2021

Manavotam Singh ,
Keore McKenzie ,
Mark L. Hudak ,
Anil K. Gehi  and
Sunita J. Ferns Open the ORCID record for Sunita J. Ferns [Opens in a new window]
Manavotam Singh
Affiliation:
MedStar Heart and Vascular Institute, MedStar Washington Hospital Center, Washington, DC, USA
Keore McKenzie
Affiliation:
Department of Pediatrics, University of Florida School of Medicine, Jacksonville, FL, USA
Mark L. Hudak
Affiliation:
Department of Pediatrics, University of Florida School of Medicine, Jacksonville, FL, USA
Anil K. Gehi
Affiliation:
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
Sunita J. Ferns*
Affiliation:
Department of Pediatrics, University of Florida School of Medicine, Jacksonville, FL, USA
*
Author for correspondence: S. J. Ferns, MD, Children’s Heart Center, 841 Prudential Drive (Suite 100), Jacksonville, FL32207, USA. Tel: +1-904-633-4110; Fax: +1-904-633-4111. E-mail: sunita.ferns@jax.ufl.edu
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Abstract

Aim:

This retrospective case series study sought to describe the safety and clinical effectiveness of propafenone for the control of arrhythmias in children with and without CHD or cardiomyopathy.

Methods:

We reviewed baseline characteristics and subsequent outcomes in a group of 63 children treated with propafenone at 2 sites over a 15-year period Therapy was considered effective if no clinically apparent breakthrough episodes of arrhythmias were noted on the medication.

Results:

Sixty-three patients (29 males) were initiated on propafenone at a median age of 2.3 years. CHD or cardiomyopathy was noted in 21/63 (33%). There were no significant differences between demographics, clinical backgrounds, antiarrhythmic details, side effect profiles, and outcomes between children with normal hearts and children with CHD or cardiomyopathy. Cardiac depression at the initiation of propafenone was more common amongst children with CHD or cardiomyopathy compared to children with normal hearts. Systemic ventricular function was diminished in 15/63 patients (24%) prior to starting propafenone and improved in 8/15 (53%) of patients once better rhythm control was achieved. Other than one child in whom medication was stopped due to gastroesophageal reflux, no other child experienced significant systemic or cardiac side effects during treatment with propafenone. Propafenone achieved nearly equal success in controlling arrhythmias in both children with normal hearts and children with congenital heart disease or cardiomyopathy (90% versus 86%, p = 0.88).

Conclusion:

Propafenone is a safe and effective antiarrhythmic medication in children.

Keywords

Propafenonepaediatricsantiarrhythmiccongenital heart disease
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 4 , April 2022 , pp. 623 - 627
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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