Intravenous sotalol for the termination of supraventricular tachycardia and atrial fibrillation and flutter: A multicenter, randomized, double-blind, placebo-controlled study

Sung, Ruey J.; Tan, Hanno L.; Karagounis, Labros A.; Hanyok, James; Falk, Rodney H.; Platia, Edward V.; Das, Gopal D.; Hardy, S.

doi:10.1016/0002-8703(95)90324-0

Cited by 115 publications

(42 citation statements)

References 42 publications

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“…All studies with therapeutic sotalol regimens of less than 1.5 mg/kg or 100 mg were excluded because these doses have proven effective in the termination of VT and SVT. 2,[6][7][8][9] Studies where the stated infusion duration was more than 30 minutes were also excluded. Although it is uncertain whether longer infusions would be as effective and associated with the same risk of TdP, their application would be less desirable in an emergency setting.…”

Section: Discussionmentioning

confidence: 99%

“…7,32,43 Five patients experienced symptomatic hypotension or presyncope that did not necessitate specific treatment. 6,7 Two patients had hypotension that responded to fluid replacement, 41 two required discontinuation of therapy, 7 and two required both fluid replacement and discontinuation of therapy. 51 In one study, 30 patients were given sotalol while in VT. 2 One of 16 who received sotalol as a first drug became hypotensive, lost consciousness, and required electrical cardioversion.…”

Section: 51mentioning

confidence: 99%

“…7 There was no report of bronchospasm. Three patients experienced AV block necessitating discontinuation of sotalol infusion.…”

Section: 51mentioning

confidence: 99%

“…2 It may also prove to be useful in the termination and suppression of refractory VT 3 and VT associated with acute myocardial infarction (MI), 3,4 and to facilitate defibrillation of ventricular fibrillation. 5 Intravenous racemic sotalol terminates about 70% of cases of atrioventricular nodal reentrant and atrioventricular reciprocating tachycardias [6][7][8][9] It is not as effective as adenosine or verapamil, 10 but it may be useful for patients with recurrent or refractory supraventricular tachycardias (SVTs), particularly when calcium-channel blockers are contraindicated. The effective refractory period is usually increased after sotalol administration in all myocardial tissue, including bypass tracts, which are present in patients with Wolff-Parkinson-White (WPW) syndrome.…”

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confidence: 99%

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Meta‐analysis of the Risk of Torsades de Pointes in Patients Treated with Intravenous Racemic Sotalol

Marill

Runge

2001

Academic Emergency Medicine

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Abstract. Objective: Intravenous (IV) racemic sotalol is useful for the treatment of multiple tachydysrhythmias. The authors hypothesized that the risk of torsades de pointes (TdP) in patients treated with a single IV infusion of sotalol is lower than the 2-4% risk associated with chronic oral sotalol therapy. Methods: A MEDLINE search under the subject heading ''sotalol'' was made of all publications involving humans written in English or German from 1966 to October 1, 2000. A meta-analysis of all original reports including patients who were given a single infusion of at least 1.5 mg/kg or 100 mg of IV sotalol over 30 minutes or less was performed. Potential variables predictive of TdP were assessed. The primary outcome was the observation of TdP associated with IV sotalol infusion. Secondary measurements included hypotension, bradycardia, and worsening of congestive heart failure. All excluded studies and case reports were also examined for evidence of TdP associated with IV sotalol treatment. Results: The search included 1,005 publications. There were 37 reports in which 962 patients received IV sotalol and met the inclusion criteria. There was one report of self-terminating TdP lasting 10 seconds among the 962 patients included in the study. There was no report of TdP associated with only IV racemic sotalol administration in any of the excluded studies. If it is assumed that the risk of TdP is homogeneous in the population of patients treated with IV sotalol, then based on the 962 included patients, the rate of TdP is 0.1% (95% CI = 0.003% to 0.6%). Conclusions: The overall risk of TdP in patients treated with a single infusion of IV sotalol is low compared with that in patients given chronic oral sotalol therapy.

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Section: Discussionmentioning

confidence: 99%

Section: 51mentioning

confidence: 99%

“…7 There was no report of bronchospasm. Three patients experienced AV block necessitating discontinuation of sotalol infusion.…”

Section: 51mentioning

confidence: 99%

mentioning

confidence: 99%

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Meta‐analysis of the Risk of Torsades de Pointes in Patients Treated with Intravenous Racemic Sotalol

Marill

Runge

2001

Academic Emergency Medicine

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“…69 IV amiodarone is effective in AVNRT or accessory pathway-mediated AVRT 53,57,60,63,79 and is comparable to procainamide 69 and magnesium 126 but has less efficacy than propafenone. 58 IV flecainide 127 and IV sotalol 128,129 have also been useful in terminating PSVT due to AVNRT.…”

Section: Paroxysmal Supraventricular Tachycardia (See the Narrow-compmentioning

confidence: 99%

Part 6: Advanced Cardiovascular Life Support : Section 5: Pharmacology I: Agents for Arrhythmias

2000

Circulation

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External electrical and pharmacological cardioversion for atrial fibrillation, atrial flutter or atrial tachycardias: a network meta-analysis

Kukendrarajah,

Ahmad,

Carrington

et al. 2024

Cochrane Database of Systematic Reviews

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Intravenous sotalol for the termination of supraventricular tachycardia and atrial fibrillation and flutter: A multicenter, randomized, double-blind, placebo-controlled study

Cited by 115 publications

References 42 publications

Meta‐analysis of the Risk of Torsades de Pointes in Patients Treated with Intravenous Racemic Sotalol

Meta‐analysis of the Risk of Torsades de Pointes in Patients Treated with Intravenous Racemic Sotalol

Part 6: Advanced Cardiovascular Life Support : Section 5: Pharmacology I: Agents for Arrhythmias

External electrical and pharmacological cardioversion for atrial fibrillation, atrial flutter or atrial tachycardias: a network meta-analysis

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