[Experiences in therapy of bradycardic cardiac arrhythmias in childhood with ipratropium bromide].

Ipratropiumbromid is used in adults for a variety of bradyarrhythmias. In contrast this therapy has not yet been established in childhood, where symptomatic bradyeardias are less frequent. Since Ipratropiumbromid has less side effects (especially concerning the central nervous system) and a longer half time than atropin, we investigated the efficacy of Ipratropiumbromid in 12 children (mean age 7.2 yrs.) in the course of 2 1/2 years. We found a significant increase of the minimal and mean heart rate in Holter-Eeg-recordings. Only in 7 of 12 patients we obtained a sufficient therapeutic effect. In one patient we had to terminate the therapy because of side effects. In two patients with atrioventricular block and two children with higher degree sinus node dysfunction could be removed only by implantation of a pacemaker. In another case we observed the proarrhythmical effect of Ipratropiumbromid. Summarizing we think, that the therapy with Ipratropiumbromid may be useful in symptomatical supranodal bradyarrhythmias in childhood in regard of side effects.