Pediatric Cardiology

, Volume 32, Issue 1, pp 63–66

Use of a Cardioselective Beta-Blocker for Pediatric Patients With Prolonged QT Syndrome

  • Jose M. Moltedo
  • Jeffrey J. Kim
  • Richard A. Friedman
  • Naomi J. Kertesz
  • Bryan C. Cannon
Original Article

DOI: 10.1007/s00246-010-9819-1

Cite this article as:
Moltedo, J.M., Kim, J.J., Friedman, R.A. et al. Pediatr Cardiol (2011) 32: 63. doi:10.1007/s00246-010-9819-1

Abstract

The data on the efficacy of atenolol for long-QT syndrome (LQTS) are controversial. This study aimed to evaluate the efficacy of atenolol for pediatric patients with LQTS. A retrospective observational study investigating all patients who had LQTS treated with atenolol at two institutions was performed. The study identified 57 patients (23 boys and 34 girls) with a mean QT corrected for heart rate (QTc) of 521 ± 54 ms. The mean age of these patients at diagnosis was 9 ± 6 years. Their clinical manifestations included no symptoms (n = 33, 58%), ventricular tachycardia (n = 10, 18%), syncope (n = 6, 10%), resuscitated sudden cardiac death (n = 4, 7%), atrioventricular block (n = 2, 4%), and bradycardia or presyncope (n = 2, 3%). Of the 57 patients, 13 (22%) had a family history of sudden death. The follow-up period was 5.4 ± 4.5 years. Atenolol at a mean dose of 1.4 ± 0.5 mg/kg/day was administered twice a day for all the patients. The mean maximum heart rate was 132 ± 27 bpm on Holter monitors and 155 ± 16 bpm on exercise treadmill tests, with medication doses titrated up to achieve a maximum heart rate lower than 150 bpm on both tests. During the follow-up period, one patient died (noncompliant with atenolol at the time of death), and the remaining patients had no sudden cardiac death events. Four patients (8%) had recurrent ventricular arrhythmias, three of whom received an implantable cardioverter defibrillator (all symptomatic at the time of diagnosis). For three patients (6%), it was necessary to rotate to a different beta-blocker because of side effects or inadequate heart rate control. Atenolol administered twice daily constitutes a valid and effective alternative for the treatment of pediatric patients with LQTS.

Keywords

Atenolol Long-QT syndrome Pediatrics Therapy 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Jose M. Moltedo
    • 1
    • 2
  • Jeffrey J. Kim
    • 3
  • Richard A. Friedman
    • 3
  • Naomi J. Kertesz
    • 3
  • Bryan C. Cannon
    • 3
  1. 1.Section of Pediatric CardiologyFundacion contra las enfermedades Neurologicas de la InfanciaBuenos AiresArgentina
  2. 2.Buenos AiresArgentina
  3. 3.Section of Cardiology, Department of PediatricsBaylor College of Medicine and Texas Children’s HospitalHoustonUSA

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