Class III Antiarrhythmic Drugs: Amiodarone, Ibutilide, and Sotalol

Enhancing Electrical Cardioversion and Preventing Immediate Reinitiation of Hemodynamically Deleterious Atrial Fibrillation with Class III Drug Pretreatment

“…In a study by Tse et al, 9 20 of 64 patients had immediate reinitiation after initially successful internal cardioversion, and intravenous administration of sotalol before repeated cardioversion prevented it in 83% of patients. Sotalol, however, is a class III drug with substantial β‐blocking activity that may suppress the onset of atrial premature triggers 25 . This is therefore the first study, to our knowledge, to demonstrate that a drug with pure class III properties prevents early recurrence of AF after cardioversion.…”

Hyperacute drug-induced hepatitis with intravenous amiodarone: case report and review of the literature

“…It involves antagonism of the delayed rectifier potassium channels, in particular the rapid component, thereby increasing membrane refractoriness. This agent also affects inactivated sodium channels (Phase 0), sympathetic activity, and calcium channels (L-type) 1. Long-term therapy is associated with various adverse effects due to accumulation of the drug in tissue.…”

Efficacy and Safety of Sotalol for Refractory Tachyarrhythmias in Congenital Heart Disease

“…5,12,14 In this study, 2 patients had to discontinue sotalol secondary to adverse effects (TdP and fatigue). However, sotalol did not affect BNP/hANP levels, even in those with complicated CHD and severe heart failure.…”

“…[16][17][18][19][20] However, it can produce pulmonary toxicity and disturbances of thyroid function. 5,14 Because amiodarone is a highly lipophilic compound and affects multiple organ systems during long-term administration, 5 its use should be considered more carefully in younger patients who are not expected to reach the endpoint of administration. Compared with amiodarone, sotalol has the advantage of relatively simple pharmacokinetics.…”