The treatment of cardiac arrhythmias with sotalol

Fogelman, F.; Lightman, SL; Sillett, R. W.; McNicol, Martin W.

doi:10.1007/bf00561748

Cited by 37 publications

(6 citation statements)

References 12 publications

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“…Sotalol combines class III properties with a bblocking action (class II) [78]. The conversion rate of acute atrial fibrillation to sinus rhythm with sotalol is low and is less than with class Ia or Ic agents [79][80][81].…”

Section: Class III Agents -Action Potential Prolongationmentioning

confidence: 99%

The peri‐operative management of atrial fibrillation

Nathanson

Gajraj

1998

Anaesthesia

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SummaryAtrial fibrillation is a common arrhythmia frequently seen in surgical patients. The onset of new atrial fibrillation during the peri-operative period is less common. There are many possible precipitating factors, although volatile agents themselves may have an antifibrillatory action. The management of atrial fibrillation includes removal of any precipitating factors and treatment of the arrhythmia itself. Immediate management of acute-onset atrial fibrillation is usually direct current cardioversion. Alternatively, anti-arrhythmic drugs can be used to achieve cardioversion. In patients with rapid, chronic atrial fibrillation or those refractory to cardioversion, priority is given to control of the ventricular rate. Thrombo-embolism is a significant risk if atrial fibrillation is paroxysmal or persists for more than 48 h.

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Section: Class III Agents -Action Potential Prolongationmentioning

confidence: 99%

The peri‐operative management of atrial fibrillation

Nathanson

Gajraj

1998

Anaesthesia

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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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“…A reduction in ventricular reponse in patients with AFib and Afl is achieved by a dosage as low as 20 mg i.v. [30]. To obtain this effect an oral sotalol/cisapride solution containing 80 mg sotalol is expected to be appropriate.…”

Section: Discussionmentioning

confidence: 99%

Absorption kinetics of oral sotalol combined with cisapride and sublingual sotalol in healthy subjects

Deneer¹,

Lie-A-Huen²,

Kingma

et al. 1998

Brit J Clinical Pharma

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Aims To study the absorption kinetics of sotalol following administration of different formulations. A formulation which results in fast absorption might be useful in the episodic treatment of paroxysmal supraventricular tachycardia (SVT), atrial fibrillation (Afib) or atrial flutter (Afl).Methods In an open randomized crossover study seven healthy male volunteers were given an intravenous infusion of 20 mg sotalol, for assessing the absolute bioavailability, an oral solution containing 80 mg sotalol, an oral solution containing both 80 mg sotalol and 20 mg cisapride and an 80 mg sotalol tablet, which was taken sublingually. Results The addition of cisapride decreased the time at which maximum serum concentrations were reached (t max ) from 2.

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The treatment of cardiac arrhythmias with sotalol

Cited by 37 publications

References 12 publications

The peri‐operative management of atrial fibrillation

The peri‐operative management of atrial fibrillation

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

Absorption kinetics of oral sotalol combined with cisapride and sublingual sotalol in healthy subjects

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