Abstract
Atrioventricular reentrant tachycardia (AVRT) is the most common cause of supraventricular tachycardia in young children. In nearly 70% of cases, there is manifest preexcitation on electrocardiogram. In the rest, the accessory pathway is concealed. Drugs control AVRT by affecting conduction through the atrioventricular node (beta-blockers, digoxin, verapamil) or accessory pathway (flecainide, propafenone) or both (sotalol, amiodarone). Adenosine is the drug of choice in acute management of AVRT in hemodynamically stable children. In adenosine-resistant cases, intravenous flecainide, procainamide, esmolol, propafenone and amiodarone are other treatment options. Hypotension and bradycardia can occur during administration of these drugs. Verapamil may be used to treat AVRT using a concealed pathway. Verapamil should be avoided in infants and in patients with decreased cardiac function. In chronic management, catheter ablation is the preferred treatment in older children with frequent AVRT. In infants and small children, ablation is associated with higher risk, and pharmacologic management is recommended. Beta-blockers are the preferred first line drugs for chronic management. In patients with concealed accessory pathway, digoxin and calcium channel blockers are alternative options. Sotalol, flecainide, propafenone and amiodarone can be prescribed in resistant cases. Flecainide and propafenone should be avoided in children with structurally abnormal hearts because of a higher risk of proarrhythmia. The initiation of flecainide, propafenone and sotalol therapy is recommended in an inpatient setting to monitor for proarrhythmias.
Keywords: WPW, Wolff-Parkinson-White, SVT, arrhythmia, atenolol, metoprolol, nadolol
Current Pharmaceutical Design
Title: Pharmacological Therapy in Children with Atrioventricular Reentry: Which Drug?
Volume: 14 Issue: 8
Author(s): Christopher Ratnasamy, Marie Rossique-Gonzalez and Ming-Lon Young
Affiliation:
Keywords: WPW, Wolff-Parkinson-White, SVT, arrhythmia, atenolol, metoprolol, nadolol
Abstract: Atrioventricular reentrant tachycardia (AVRT) is the most common cause of supraventricular tachycardia in young children. In nearly 70% of cases, there is manifest preexcitation on electrocardiogram. In the rest, the accessory pathway is concealed. Drugs control AVRT by affecting conduction through the atrioventricular node (beta-blockers, digoxin, verapamil) or accessory pathway (flecainide, propafenone) or both (sotalol, amiodarone). Adenosine is the drug of choice in acute management of AVRT in hemodynamically stable children. In adenosine-resistant cases, intravenous flecainide, procainamide, esmolol, propafenone and amiodarone are other treatment options. Hypotension and bradycardia can occur during administration of these drugs. Verapamil may be used to treat AVRT using a concealed pathway. Verapamil should be avoided in infants and in patients with decreased cardiac function. In chronic management, catheter ablation is the preferred treatment in older children with frequent AVRT. In infants and small children, ablation is associated with higher risk, and pharmacologic management is recommended. Beta-blockers are the preferred first line drugs for chronic management. In patients with concealed accessory pathway, digoxin and calcium channel blockers are alternative options. Sotalol, flecainide, propafenone and amiodarone can be prescribed in resistant cases. Flecainide and propafenone should be avoided in children with structurally abnormal hearts because of a higher risk of proarrhythmia. The initiation of flecainide, propafenone and sotalol therapy is recommended in an inpatient setting to monitor for proarrhythmias.
Export Options
About this article
Cite this article as:
Ratnasamy Christopher, Rossique-Gonzalez Marie and Young Ming-Lon, Pharmacological Therapy in Children with Atrioventricular Reentry: Which Drug?, Current Pharmaceutical Design 2008; 14 (8) . https://dx.doi.org/10.2174/138161208784007644
DOI https://dx.doi.org/10.2174/138161208784007644 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Antipsychotic and Antiepileptic Drugs in Bipolar Disorder: The Importance of Therapeutic Drug Monitoring
Current Medicinal Chemistry Ebola Virus Altered Innate and Adaptive Immune Response Signalling Pathways: Implications for Novel Therapeutic Approaches
Infectious Disorders - Drug Targets Common and Less Common Peripheral Nerve Disorders Associated with Diabetes
Current Diabetes Reviews Highly Active Antiretroviral Therapy and Cardiovascular Complications in HIV-Infected Patients
Current Pharmaceutical Design Diabetes Mellitus: Novel Insights, Analysis and Interpretation of Pathophysiology and Complications Management with Imidazole-Containing Peptidomimetic Antioxidants
Recent Patents on Drug Delivery & Formulation Monoclonal Antibodies in the Treatment of Systemic Lupus Erythematosus
Current Drug Targets Pulmonary Hypertension: Clinical Presentation, Diagnosis, Treatment,and Dana Point World Symposium Highlights
Current Respiratory Medicine Reviews Prevention of Endothelial Cell Injury by Activated Protein C: The Molecular Mechanism(s) and Therapeutic Implications
Current Vascular Pharmacology Magnetic Digital Microfluidics for Point-of-Care Testing: Where Are We Now?
Current Medicinal Chemistry Postoperative Care of the Transplanted Patient
Current Cardiology Reviews Myelodysplastic Syndromes: Review of Pathophysiology and Current Novel Treatment Approaches
Current Cancer Drug Targets MDMA Administration and Heat Shock Proteins Response: Foreseeing a Molecular Link
Current Pharmaceutical Biotechnology The Influence of Genetic Variations and Drug Interactions Based on Metabolism of Antidepressants and Anticonvulsants
Current Drug Metabolism Effects of Statins on Blood Pressure: A Review of the Experimental and Clinical Evidence.
Current Vascular Pharmacology Synthesis of 5-Arylidene Barbiturates: A Novel Class of DPPH Radical Scavengers
Letters in Drug Design & Discovery Does Daily Dialysis Improve Hypertension in Chronic Haemodialysis Patients?
Current Hypertension Reviews Cerebroprotective Functions of HO-2
Current Pharmaceutical Design Cardiac Adrenomedullin: Its Role in Cardiac Hypertrophy and Heart Failure
Current Medicinal Chemistry - Cardiovascular & Hematological Agents Geriatric Psychopharmacology in Acute Settings
Current Psychopharmacology Utilization of Evidence-Based Secondary Prevention Medications at the Time of Discharge in Patients with Acute Coronary Syndrome (ACS) in Qatar
Current Vascular Pharmacology