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Neonatal Intensive Care Drug Manual
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| bet | 178/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Atrial fibrillation — Atrial fibrillation is uncommon in children and most paediatric cases are associated with CHD, cardiomyopathy or Wolff-Parkinson-White syndrome.[16] The management of neonatal atrial fibrillation is unclear with use of digoxin and cardioversion reported.[17, 18] In adult populations, systematic review found when digoxin was compared with all control interventions there was no evidence of a difference in all-cause mortality (RR 0.82; CI 0.02 to 31.2); serious adverse events (RR 1.65; CI 0.24 to 11.5); quality of life; heart failure (RR 1.05 CI 0.00 to 1141.8) or stroke (RR 2.27; CI 0.00 to 7887.3). Digoxin was superior compared with placebo in reducing the heart rate, but inferior compared with beta blockers. Meta-analyses on acute heart rate control showed that digoxin was inferior compared with both calcium antagonists (MD 21.0 bpm; CI -30.3 to 72.3) and with amiodarone (MD 14.7 bpm; CI -0.58 to 30.0). Meta-analysis on acute conversion to sinus rhythm showed that digoxin compared with amiodarone reduced the probability of converting atrial fibrillation to sinus rhythm (RR 0.54; CI 0.13 to 2.21).[19]
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