Is Routine Electrocardiography Necessary Before Initiation of Propranolol for Treatment of Infantile Hemangiomas?

Kevin B. Yarbrough, Megha M. Tollefson, Alfons L. Krol, Sabra L. Leitenberger, Julianne A. Mann, Carol J. MacArthur

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: In recent years propranolol has become the treatment of choice for infantile hemangiomas (IHs). There is broad variation in the approach to propranolol initiation in clinical practice. This retrospective study explored the effectiveness of routine pre-treatment ECG in screening infants being considered for systemic treatment with propranolol. Methods: All patients seen in the outpatient pediatric dermatology clinics at Oregon Health and Sciences University (OHSU) and The Mayo Clinic Rochester (MCR), as well as those seen in multidisciplinary vascular anomalies clinics, who had ECGs obtained prior to planned initiation of propranolol for treatment of IH from 2008 to 2013, were identified. A total of 162 patients were included in the study. Results: We found that 43% (69) of routine ECGs were read as abnormal, leading to 28 formal consultation appointments with pediatric cardiologists. After either formal consultation or informal discussion with cardiology, no patients with initially “abnormal” ECGs were ultimately excluded from treatment with propranolol based on routine ECG findings. Additionally no patients in our cohort experienced an adverse effect during treatment that could have been predicted or prevented by ECG prior to initiation of the propranolol. Conclusion: Our findings suggest that routine ECG may not be necessary or helpful in the vast majority of patients treated with propranolol for IHs.

Original languageEnglish (US)
Pages (from-to)615-620
Number of pages6
JournalPediatric Dermatology
Volume33
Issue number6
DOIs
StatePublished - Nov 1 2016

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Hemangioma
Propranolol
Electrocardiography
Therapeutics
Referral and Consultation
Pediatrics
Dermatology
Cardiology
Blood Vessels
Appointments and Schedules
Outpatients
Retrospective Studies
Health

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Dermatology

Cite this

Is Routine Electrocardiography Necessary Before Initiation of Propranolol for Treatment of Infantile Hemangiomas? / Yarbrough, Kevin B.; Tollefson, Megha M.; Krol, Alfons L.; Leitenberger, Sabra L.; Mann, Julianne A.; MacArthur, Carol J.

In: Pediatric Dermatology, Vol. 33, No. 6, 01.11.2016, p. 615-620.

Research output: Contribution to journalArticle

Yarbrough, Kevin B. ; Tollefson, Megha M. ; Krol, Alfons L. ; Leitenberger, Sabra L. ; Mann, Julianne A. ; MacArthur, Carol J. / Is Routine Electrocardiography Necessary Before Initiation of Propranolol for Treatment of Infantile Hemangiomas?. In: Pediatric Dermatology. 2016 ; Vol. 33, No. 6. pp. 615-620.
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