PMID- 32014568 OWN - NLM STAT- MEDLINE DCOM- 20210616 LR - 20210616 IS - 1556-3871 (Electronic) IS - 1547-5271 (Linking) VI - 17 IP - 6 DP - 2020 Jun TI - Adverse event rate during inpatient sotalol initiation for the management of supraventricular and ventricular tachycardia in the pediatric and young adult population. PG - 984-990 LID - S1547-5271(20)30074-6 [pii] LID - 10.1016/j.hrthm.2020.01.022 [doi] AB - BACKGROUND: Sotalol is an important antiarrhythmic drug in the pediatric population. Given the risk of proarrhythmia, sotalol is initiated in inpatient settings, with adult studies as recent as 2015 supporting this practice. OBJECTIVE: The purpose of this study was to determine the frequency of adverse events (AEs) during sotalol initiation for the management of atrial, supraventricular, or ventricular arrhythmias in pediatric patients. METHODS: A retrospective cohort analysis of pediatric patients 21 years or younger initiated on oral sotalol for supraventricular tachycardia or ventricular tachycardia (VT) at Boston Children's Hospital from January 1, 2007, through July 1, 2016, was performed. The primary end point was an AE defined as significant bradycardia, new or increased ventricular arrhythmias, conduction block, or corrected QT interval (QTc) prolongation, resulting in dose reduction or cessation. RESULTS: There were 190 patients who met inclusion criteria, with 110 patients (58%) 6 months or younger. A total of 115 patients (60%) had congenital heart disease. Arrhythmias for which sotalol was initiated included atrioventricular reciprocating tachycardia/atrioventricular nodal reciprocating tachycardia (n = 105 [55%]), atrial flutter (n = 31 [16%]), ectopic atrial tachycardia (n = 26 [14%]), VT (n = 21 [11%]), and atrial fibrillation (n = 7 [4%]). The median pre-sotalol QTc was 438 ms (interquartile range 348-530 ms). Five patients (3%) (aged 0.1-18 years) had AEs including bradycardia <40 beats/min (n = 2) and <100 beats/min (n = 1) and QTc prolongation (n = 2). All 5 patients with AEs had repaired congenital heart disease. CONCLUSION: The incidence of AEs in pediatric patients initiating sotalol for atrial tachycardia, supraventricular tachycardia, or VT is low (3%), with no deaths or malignant rhythms reported in this series. CI - Copyright (c) 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. FAU - Chandler, Stephanie F AU - Chandler SF AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Chu, Esther AU - Chu E AD - Department of Pharmacy, Boston Children's Hospital, Boston, Massachusetts. FAU - Whitehill, Robert D AU - Whitehill RD AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Bevilacqua, Laura M AU - Bevilacqua LM AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Bezzerides, Vassilios J AU - Bezzerides VJ AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - DeWitt, Elizabeth S AU - DeWitt ES AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Alexander, Mark E AU - Alexander ME AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Abrams, Dominic J AU - Abrams DJ AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Triedman, John K AU - Triedman JK AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Walsh, Edward P AU - Walsh EP AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. FAU - Mah, Douglas Y AU - Mah DY AD - Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts. Electronic address: douglas.mah@cardio.chboston.org. LA - eng PT - Journal Article DEP - 20200201 PL - United States TA - Heart Rhythm JT - Heart rhythm JID - 101200317 RN - 0 (Anti-Arrhythmia Agents) RN - A6D97U294I (Sotalol) SB - IM MH - Anti-Arrhythmia Agents/adverse effects MH - Atrial Fibrillation/*chemically induced/epidemiology MH - Child, Preschool MH - *Electrocardiography, Ambulatory MH - Female MH - Follow-Up Studies MH - Humans MH - Incidence MH - Male MH - Retrospective Studies MH - Risk Factors MH - Sotalol/*adverse effects MH - Tachycardia, Supraventricular/*drug therapy/physiopathology MH - Tachycardia, Ventricular/*drug therapy/physiopathology MH - United States/epidemiology OTO - NOTNLM OT - Adverse events OT - Pediatrics OT - Sotalol OT - Supraventricular tachycardia OT - Ventricular tachycardia EDAT- 2020/02/06 06:00 MHDA- 2021/06/17 06:00 CRDT- 2020/02/05 06:00 PHST- 2019/04/28 00:00 [received] PHST- 2020/01/24 00:00 [accepted] PHST- 2020/02/06 06:00 [pubmed] PHST- 2021/06/17 06:00 [medline] PHST- 2020/02/05 06:00 [entrez] AID - S1547-5271(20)30074-6 [pii] AID - 10.1016/j.hrthm.2020.01.022 [doi] PST - ppublish SO - Heart Rhythm. 2020 Jun;17(6):984-990. doi: 10.1016/j.hrthm.2020.01.022. Epub 2020 Feb 1.