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Ivabradine in Postural Orthostatic Tachycardia Syndrome: Preliminary Experience in Children.
Delle Donne, Grazia; Rosés Noguer, Ferran; Till, Jan; Salukhe, Tushar; Prasad, Sanjay K; Daubeney, Piers E F.
Afiliação
  • Delle Donne G; Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK.
  • Rosés Noguer F; Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK.
  • Till J; Vall d'Hebron University Hospital, Barcelona, Spain.
  • Salukhe T; Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK.
  • Prasad SK; Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK.
  • Daubeney PEF; Royal Brompton Hospital, Sydney St, London, SW3 6NP, UK.
Am J Cardiovasc Drugs ; 18(1): 59-63, 2018 Feb.
Article em En | MEDLINE | ID: mdl-29027608
ABSTRACT

OBJECTIVE:

Ivabradine is a selective and specific inhibitor of the I(f) current in the sinoatrial and atrioventricular nodes. It decreases heart rate and myocardial oxygen consumption at rest and during exercise. It is used in adults for management of heart failure and angina, but promising results have been obtained in postural orthostatic tachycardia syndrome (POTS). There is little experience of ivabradine in childhood, although it is used on a compassionate basis. Our aim was to review our experience of ivabradine in a retrospective evaluation of pediatric patients with POTS.

METHODS:

We evaluated all patients younger than 18 years for whom ivabradine had been prescribed for this indication, from February 2008 to June 2014.

RESULTS:

Twenty-two patients were identified (15 female). Median age was 14.5 years (11-17 years). The ivabradine dosage after up-titration was 0.1 mg/kg per dose twice daily. In 15 (68%) symptoms improved. Ivabradine was suspended in five, but only in one for worsening of symptoms. There was a reduction in heart rate on resting electrocardiogram (EKG) from a mean (standard deviation) of 82.5 (13.6) bpm to a mean of 71 (16.5) bpm (p = 0.007). No patient had increased duration of QTc (p = 0.44). One (4.5%) experienced phosphenes.

CONCLUSIONS:

From this initial experience, ivabradine is safe in patients younger than 18 years with POTS. We observed improvement of symptoms in 68% and phosphenes in less than 5%. Further studies are needed to assess the safety in a randomized control setting.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Benzazepinas / Fármacos Cardiovasculares / Síndrome da Taquicardia Postural Ortostática Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Am J Cardiovasc Drugs Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Benzazepinas / Fármacos Cardiovasculares / Síndrome da Taquicardia Postural Ortostática Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies Limite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: Am J Cardiovasc Drugs Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / TERAPIA POR MEDICAMENTOS Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Reino Unido