TREATMENT OF VENTRICULAR ARRHYTHMIAS IN CHILDREN WITHOUT STRUCTURAL HEART-DISEASE WITH CLASS-IC AGENTS AS GUIDED BY INVASIVE ELECTROPHYSIOLOGY

Although the efficacy of class IC antiarrhythmic agents in the treatment of supraventricular and ventricular arrhythmias in adults has been clearly demonstrated, serious proarrhythmic effects have been reported.1 These agents have also proven useful in the pediatric population, but there is growing concern that similar proarrhythmic potential exists.2,3 Recognizing that these drugs, although very useful, may also be deadly, we have adopted a protocol at the Medical University of South Carolina that uses invasive ventricular stimulation after drug administration to help assess the risk/benefit ratio of these agents in the treatment of ventricular arrhythmias. Since mid-1987, all 23 children with ventricular arrhythmias treated with IC agents have had invasive stimulation performed after drug administration to evaluate efficacy or proarrhythmia, or both. Ten of these children with structurally normal hearts, treated solely with IC agents, were tested in the electrophysiology laboratory both before and after drug administration; data from these 10 patients were used in this investigation (Table I). {A table is presented}. © 1990.