Pediatric Cardiology and Cardiac Surgery
Vol.25 No.4 2009 (616-622)
Kenichiro Yamamura,1) Mamie Watanabe,1) Aiko Kumamoto,1) Eiji Morihana,1) Tetsuji Yuge,1) Takuro Ohno,1) Yutaka Imoto,2) Akira Sese,2) Hiroomi Yoshino,3) Jun Muneuchi,4) and Kunitaka Joo1)
Departments of 1)Pediatrics, 2)Cardiovascular Surgery, and 3)Anesthesia, Kyushu Koseinenkin Hospital, and 4)Department of Pediatrics, Kyushu University Hospital, Fukuoka, Japan
Abstract
The efficacy of intravenous amiodarone for life-threatening arrhythmias in pediatric patients has been established in Western countries. However we have just started to use this drug officially in Japan, and there is as yet no report in Japanese children. We experienced five infants and children treated with intravenous administration of amiodarone for life-threatening arrhythmias in our hospital from 2004 to 2007. The patients’ ages ranged from 18 days to 3 years (median, 2 months). There were three patients with junctional ectopic tachycardia, one with paroxysmal supraventricular tachycardia and one with ventricular fibrillation and tachycardia. Initial 5 mg/kg boluses were given in each case, and continuous infusions of 5 to 20 mg/kg/day were followed with monitoring of beneficial and adverse effects. In two cases, arrhythmias were terminated from five to ten minutes. Even in the cases whose arrhythmias did not terminate immediately, hemodynamic states improved in several hours, assisted with atrial pacing after decreasing the heart rate. Although transient sinus bradycardia, junctional rhythm and decrease in blood pressure occurred, no severe side effects that needed discontinuation of the drug were noted in any patient. Intravenous amiodarone seems to be very effective for life-threatening arrhythmias in Japanese children. But mild side effects often will be observed. More clinical experiences are needed to determine the appropriate dosage.