Prediction of antiarrhythmic therapy effectiveness in children

Abstract

Aim. To optimize treatment tactics in children with arrhythmias based on the evaluation and prediction of the therapy efficacy.Material and methods. Prospective cohort study was performed from 2007 to 2017 A total of 100 patients aged 0 to 7 years with different types of significant arrhythmias received prophylactic antiarrhythmic therapy. Data of medical history, 12-lead electrocardiography (ECG), Holter ECG monitoring, and echocardiography were studied. To verify electrophysiological variant of tachycardia, some patients underwent transesophageal electrophysiologic study.Results. The study showed that antiarrhythmic drug therapy was most efficacious in patients till one year old without signs of arrhythmogenic cardiomyopathy (ACM). Older age of children, the presence of pronounced ACM manifestations are factors that increase the risk of ineffective AAT. Based on the data obtained, a multifactor model was developed to predict the effectiveness of prolonged antiarrhythmic therapy.Conclusion. The study showed that age and intracardiac hemodynamic status affected the efficacy of antiarrhythmic therapy. Proposed model allowed to avoid unnecessary prolonged pharmacological load and to timely administer other methods of treatment in case when ineffective result of the antiarrhythmic therapy was predicted.

Keywords

• children
• arrhythmia
• arrhythmogenic cardiomyopathy
• prediction model
• prolonged antiarrhythmic therapy