High-dose propranolol therapy in the management of supraventricular tachycardia

Pickoff, Arthur S.; Zies, Leonor; Ferrer, Pedro L.; Tamer, Dolores; Wolff, Grace S.; García, Otto L.; Gelband, Henry

doi:10.1016/s0022-3476(79)80381-9

Cited by 39 publications

(17 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1-3) suggests that the electrophysiologic changes in the adult dog seem to be greatest after the 0.05-0.1 mg/kg doses, whereas for the neonates changes ap pear to be more evident only at higher doses (>0.2 mg/kg). This difference in part may be the basis of the previous clinical descrip tion of relatively higher dosage requirements of propranolol in young infants treated for supraventricular tachycardia [2], The possi bility that differences in pharmacokinetic handling of propranolol between neonates and adults account for some of the observed differences cannot be excluded in this study.…”

Section: Ventricular Refractorinessmentioning

confidence: 79%

“…Propranolol is widely used as an antiarrhythmic agent in newborns and young in fants for the treatment of supraventricular tachycardia [1,2], Nevertheless information regarding the electrophysiologic effects of propranolol on the immature cardiac con duction system is scant and is essentially limited to studies of the sinus node [5,6], These previous studies suggested that the…”

Section: Discussionmentioning

confidence: 99%

“…In both groups the pacing interval resulting in atrioventricular (AV) nodal Wencke bach was increased significantly by propranolol; however, the increase was again less in the neonates than in the adults. There were comparable dose-dependent increases in atrial and ventricular refractoriness in both neonate and adult groups.Propranolol is widely used as an antiarrhythmic agent in newborns and young in fants [1,2], yet little data is available regard ing the quantitative cardiac electrophysio logic effects of propranolol on the immature heart. In this study the dose-response elec trophysiologic effects of intravenous pro pranolol were evaluated in the intact neona tal canine.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Electrophysiologic Effects of Intravenous Propranolol in the Intact Immature Mammalian Heart

Young¹,

Fournier²,

Stolfi³

et al. 1988

Dev Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

Using intracardiac electrogram recording and stimulation techniques, 13 neonatal puppies (3-15 days) and 9 adult dogs were studied following cumulative doses of intravenous propranolol. Although propranolol caused a dose-dependent increase in the sinus cycle length in both groups, the increase was significantly less in the neonates than in the adults. In both groups the pacing interval resulting in atrioventricular (AV) nodal Wenckebach was increased significantly by propranolol; however, the increase was again less in the neonates than in the adults. There were comparable dose-dependent increases in atrial and ventricular refractoriness in both neonate and adult groups.

show abstract

Section: Ventricular Refractorinessmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Electrophysiologic Effects of Intravenous Propranolol in the Intact Immature Mammalian Heart

Young¹,

Fournier²,

Stolfi³

et al. 1988

Dev Pharmacol Ther

Self Cite

View full text Add to dashboard Cite

show abstract

“…The largest sets of data regarding efficacy and safety of propranolol come not from studies of hypertensive children but instead from studies of children with various cardiac conditions (aortic coarctation, hypertrophic cardiomyopathy, arrhythmias [46][47][48] or with portal hypertension. 49 Propranolol has been shown to be an effective treatment for these conditions, with an acceptable incidence of adverse effects.…”

Section: Beta Adrenergic Blockers and Combined A-and B-adrenergic Blomentioning

confidence: 99%

Management of Hypertension in the Young: Role of Antihypertensive Medications

Flynn¹

2011

Journal of Cardiovascular Pharmacology

View full text Add to dashboard Cite

Traditionally, antihypertensive medications were used in few children or adolescents, usually just those with underlying renal or other organ system disease. However, with recent data suggesting that the incidence of primary hypertension may be increasing in the young, it is possible that more children and adolescents will be prescribed antihypertensive agents. This article will review currently available pediatric data on the use of calcium channel blockers, agents affecting the renin-angiotensin-aldosterone system and other classes of antihypertensive medications in children, highlighting appropriate indications and safety considerations. Guidelines for use of antihypertensive medications, including choice of initial agent and how to prescribe appropriately, will be presented.

show abstract

“…Side effects of propranolol, such as bradycardia, congestive heart failure, bronchospasm, and hypoglycaemia, are well recognised in adults but seem to be rare in infancy even at high doses. 2 We report the case of a child with tetralogy of Fallot who was treated with propranolol and in whom continued episodes of pallor and near syncope seemed to be caused by propranolol induced bradycardia.…”

mentioning

confidence: 98%

Propranolol induced bradycardia in tetralogy of Fallot.

Clark

Chan²,

Gibbs³

1989

Heart

View full text Add to dashboard Cite

SUMMARY When an 18 month old girl who had tetralogy of Fallot and episodes of severe cyanosis with loss of consciousness was treated with propranolol there was some improvement. But when the dose was increased she had further episodes of near syncope. Holter monitoring showed extreme intermittent bradycardia with pauses of up to 2-6 seconds. The episodes of near syncope and the bradycardia resolved after propranolol was stopped.Apparent failure of propranolol treatment may on rare occasions be related to drug induced bradycardia rather than to continued episodes of severe cyanosis.Propranolol is widely accepted as an effective palliation for tetralogy of Fallot complicated by episodes of severe cyanosis.' Side effects of propranolol, such as bradycardia, congestive heart failure, bronchospasm, and hypoglycaemia, are well recognised in adults but seem to be rare in infancy even at high doses.2 We report the case of a child with tetralogy of Fallot who was treated with propranolol and in whom continued episodes of pallor and near syncope seemed to be caused by propranolol induced bradycardia. Case reportAn 18 month old Asian girl with tetralogy of Fallot had typical episodes of severe cyanosis during which she became distressed and then limp. Sometimes she lost consciousness for up to 10 minutes. She weighed 8 kg and she was treated with propranolol 5 mg three times a day. This seemed to abolish the attacks. During a subsequent outpatient visit, however, she had a prolonged episode of severe cyanosis and lost consciousness. She was admitted to hospital and the dose ofpropranolol was increased to 8 mg three times a day. After this she had several episodes each day when she became pale and suffered near syncope. Unlike her usual episodes these attacks were not associated with preceding cyanosis or distress. Because she had intermittent sinus bradycardia during a 12 lead electrocardiogram, 24 hour Holter

show abstract

High-dose propranolol therapy in the management of supraventricular tachycardia

Cited by 39 publications

References 11 publications

Electrophysiologic Effects of Intravenous Propranolol in the Intact Immature Mammalian Heart

Electrophysiologic Effects of Intravenous Propranolol in the Intact Immature Mammalian Heart

Management of Hypertension in the Young: Role of Antihypertensive Medications

Propranolol induced bradycardia in tetralogy of Fallot.

Contact Info

Product

Resources

About