Encainide for resistant supraventricular tachycardia in children: follow-up report. Am J Cardiol 1988 Dec 20;62(19):50L-54L
Date
12/20/1988Pubmed ID
3144168DOI
10.1016/0002-9149(88)90016-1Scopus ID
2-s2.0-0024263754 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
Forty-one children (26 weeks gestational age to 20 years) with drug-resistant supraventricular tachycardia were treated with oral encainide, and 29 were followed for 3 to 34 months (mean 15). Diagnoses obtained by electrocardiographic criteria (23 patients) or electrophysiologic testing (18 patients) included permanent junctional reciprocating tachycardia in 15 children, paroxysmal atrioventricular reciprocating tachycardias (AVRT) in 13, atrial ectopic tachycardia in 4, atrial flutter in 1, chaotic atrial tachycardia in 5 and junctional ectopic tachycardia in 3. Encainide was completely effective in 54% (22 of 41 study patients) and partially effective in an additional 24% (10 of 41 patients), when combined with propranolol or verapamil. Within 1 month, 13 (32%) discontinued encainide for inefficacy or intolerance. Encainide was most effective in the treatment of permanent junctional reciprocating tachycardia (60% effective) and AVRT (69% effective). It controlled only 40% of primary atrial tachycardias. Encainide was well tolerated on a long-term basis in patients not experiencing symptoms during initiation. In study infants younger than age 6 months, encainide was associated with excessive QRS aberrancy during initiation in 4 of 13 (31%), compared with 3 of 28 (11%) in older children. Ventricular proarrhythmia occurred in 2 children and 1 died suddenly. Mean effective encainide dose was 3.5 mg/kg/day or 86 mg/m2/day. In 4 children who had nonextensive metabolism of encainide, the drug was ineffective. Encainide is effective in the treatment of some resistant forms of permanent junctional reciprocating tachycardia and AVRT in otherwise healthy children. Children younger than age 6 months and those with either previous proarrhythmic events or severe cardiac dysfunction appear to have a high incidence of adverse effects.
Author List
Strasburger JF, Smith RT Jr, Moak JP, Gothing C, Garson A JrAuthor
Janette F. Strasburger MD Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Administration, OralAdolescent
Anilides
Anti-Arrhythmia Agents
Child
Child, Preschool
Drug Therapy, Combination
Encainide
Female
Fetal Diseases
Flecainide
Follow-Up Studies
Humans
Infant
Infant, Newborn
Male
Pregnancy
Tachycardia, Supraventricular
