Long‐Term Sotalol Therapy in Patients with Arrhythmias

Simón, A.; Berman, Edel

doi:10.1002/j.1552-4604.1979.tb02521.x

Cited by 28 publications

(4 citation statements)

References 10 publications

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“…5 Subsequent studies in patients have confirmed that sotalol administered over the both the short and long term lengthens repolarization and refractoriness in the heart.7-9 Its so-called class III5 antiarrhythmic actions have also been confirmed from the direct recordings of monophasic action potentials via suction electrodes in man.7-9 However, there remains a paucity of data dealing with the effect of sotalol on cardiac arrhythmias. [10][11][12][13][14] The purpose of the the present study was to evaluate the efficacy and safety of sotalol in patients with symptomatic, sustained, life-threatening ventricular tachyarrhythmias. The study was conducted in two parts.…”

mentioning

confidence: 99%

Electrophysiologic and antiarrhythmic effects of sotalol in patients with life-threatening ventricular tachyarrhythmias.

Nademanee¹,

Feld²,

Hendrickson³

et al. 1985

Circulation

151

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Sotalol is a unique fl-blocker that lengthens cardiac repolarization and effective refractory period (ERP). Its efficacy after intravenous (1.5 mg/kg) and oral (160 to 480 mg bid) administration was therefore evaluated in 37 patients with refractory recurrent ventricular tachycardia/fibrillation (VT/VF). Thirty-five patients, 33 with inducible VT/VF, underwent electrophysiologic testing. Intravenous sotalol lengthened the ERP in the atrium ( + 24.6%, p .01), atrioventricular node ( + 24.9%, p < .01), and ventricle (+ 14.9%, p < .01). It also significantly lengthened sinus node recovery time, corrected QT interval (QTc), and the AH interval, but not the HV interval. Sotalol prevented reinduction of VT/VF in 15 patients (45.5%). Twenty-five of the 33 patients (15 with positive results of electrophysiologic tests; 10 with negative results) were given oral sotalol. The drug was ineffective in seven (26.9%) and aggravated arrhythmia in one (3.8%). In four patients sotalol was withdrawn because of side effects; arrhythmias recurred late in two (7.7%). Eleven patients (42.3%) have continued on oral sotalol over a mean follow-up period of 9.2 + 8.6 months. Sotalol reduced (n = 21) total premature ventricular complex (PVC) count on the Holter electrocardiogram by 73% (p < .01), paired PVCs by 89% (p < .01), and beats of ventricular tachycardia by 95% (p < .01). In 52% (n = 11), total reduction in PVCs was at least 85%, and incidence of paired and tachycardiac beats was reduced at least 90% (group A). In the remainder (n = 10), PVC suppression was not significant (group B). Group A included nine patients with nonreinducible VT/VF and two in whom it was reinducible; in group B, eight of 10 patients had reinducible VT/VF. The difference between the two groups (Fisher exact test) was significant (p < .01). The prevention of reinduction of VT/VF by intravenous sotalol and suppression of spontaneously occurring arrhythmias by the oral drug were both predictive of longterm drug efficacy. Sotalol is a significant advance in the short-and long-term management of lifethreatening ventricular tachyarrhythmias. Circulation 72, No. 3, 555-564, 1985. ALTHOUGH SOTALOL was introduced as a specific ,8-blocking drug 24 Protocol. All patients were admitted to the coronary care unit for continuous electrocardiographic monitoring. Previously prescribed antiarrhythmic drugs were discontinued for at least five elimination half-lives of these agents. Whenever possible a 24 hr ambulatory electrocardiographic recording was obtained at a time the patients were not taking any other antiarrhythmic drugs. This recording served as a baseline with respect to the spontaneously occurring tachyarrhythmias and was subsequently used for gauging the efficacy of drug therapy. Thirty-five patients underwent electrophysiologic studies for the evaluation of the effects of 1.5 mg/kg iv sotalol hydrochloride (BristolMyers, Evansville, IN), administered over a period of 5 to 10 min, on the inducibility of ventricular tachycardia relative to the electrop...

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mentioning

confidence: 99%

Electrophysiologic and antiarrhythmic effects of sotalol in patients with life-threatening ventricular tachyarrhythmias.

Nademanee¹,

Feld²,

Hendrickson³

et al. 1985

Circulation

151

View full text Add to dashboard Cite

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“…In 27 patients with ongoing atrial fibrillation/flutter, 1 1 / 16 patients responded to sotalol at an average intravenous dose of 0.7 mg/kg (68). Similarly, intravenous sotalol(40-100 mg) terminated atrial fibrillation/flutter in 6/ 1 1 other patients (58).…”

Section: Supraventricular Arrhythmiasmentioning

confidence: 99%

“…Neither arrhythmogenic nor adverse effects were observed. Oral sotalol was also effective in uncontrolled trials, both acutely and chronically, in patients with PVCs and various types of underlying heart disease (5,44,58). In a study that examined the relationship among P-adrenoceptor antagonism, QTc prolongation, plasma levels of sotalol, and PVC suppression in 17 patients, Wang et al (72) concluded that (a) sota-lo1 was effective in a significant number of patients who had previously failed to respond to conventional @-adrenoceptor antagonists, (b) QTc prolongation occurred at significantly higher doses than P-adrenoceptor antagonism, and (c) QTc prolongation probably contributed to the antiarrhythmic activity of sotalol.…”

Section: Complex and Repetitive Pvcsmentioning

confidence: 99%

“…Consequently, sotalol was effective in reentrant SVT involving either the AV node and/or accessory pathways. In an open trial, Simon and Berman (58) reported that all 13 patients examined with paroxysmal SVT given oral daily doses of sotalol ranging from 80 to 320 mg were controlled, 6 of whom were diagnosed as having the Wolff-Parkmson-White (WPW) syndrome.…”

Section: Supraventricular Arrhythmiasmentioning

confidence: 99%

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Sotalol—Pharmacological and Antiarrhythmic Effects

Antonaccio

Gomoll

1988

Cardiovascular Drug Reviews

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Sotalol (MJ 1999, MJ 5763) ( Fig. 1) is 4-(2-isopropylamino-l-hydroxyethyl) methanesulfonanilide, which has been shown to be a competitive antagonist at @-adrenergic receptor sites and to be devoid of membrane-stabilizing as well as a-blocking properties and agonist activities on adrenergic end organs in general. Sotalol exhibits no preferential actions on PI-(inotropic, chronotropic, intestinal relaxant, lipid-metabolizing) or p2-(vascular relaxant, bronchodilator, uterine relaxant, liver/skeletal muscle glycogenolysis) responses.In addition to its Class I1 (@-blockade) antiarrhythmic effects, sotalol also increases the action potential duration (APD) in vitro and prolongs atrial and ventricular repolarization in vivo, criteria that satisfy Class I11 antiarrhythmic activity. The focus of this review will be on the antiarrhythmic activity of sotalol, although its antianginal and antihypertensive effects are also well documented (see 59,60). AUTONOMIC ACTIONS Nonclinical Data: In VitroSotalol blocked the inhibitory effects of equiactive concentrations of epinephrine and isoproterenol on oxytocin-induced contractions of the isolated rat uterine horn (33,38). The failure of sotalol to antagonize the uterine relaxant actions of papaverine on this tissue provided evidence for the specificity of its action(s) on only @-adrenergic receptors. Effective @-blocking concentrations of dl-, d-, and I-sotalol were shown to be highly selective in attenuating isoproterenol-induced relaxation because they neither affected the normal tone of the tracheal smooth muscle nor significantly antagonized either histamine-induced contractions or papaverine-induced relaxation of the preparations (38).Sotalol effectively blocked isoproterenol-induced positive inotropic and chronotropic responses of the isolated rabbit right atrial preparation (38,63). Sotalol itself

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Sotalol

Cobbe¹

1989

Antiarrhythmic Drugs

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Long‐Term Sotalol Therapy in Patients with Arrhythmias

Cited by 28 publications

References 10 publications

Electrophysiologic and antiarrhythmic effects of sotalol in patients with life-threatening ventricular tachyarrhythmias.

Electrophysiologic and antiarrhythmic effects of sotalol in patients with life-threatening ventricular tachyarrhythmias.

Sotalol—Pharmacological and Antiarrhythmic Effects

Sotalol

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