Relation between ventricular function and antiarrhythmic responses to sotalol

Singh, Steven; Chen, Yiwang; Cohen, Andrew I.; Obeid, Maria; Tracy, Cynthia M.; Woosley, Raymond L.; Fletcher, Ross D.

doi:10.1016/0002-9149(89)90850-3

Cited by 16 publications

(3 citation statements)

References 7 publications

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“…In humans, considerable clinical evidence documents PO sotalol's lack of effect on systolic function (LV EF determined by radionuclide angiography) in the majority of cases. [24][25][26][27] However, most of these studies evaluated LV EF after more long-term treatment, which could explain the differences in our findings. Interestingly, one of the previously mentioned invasive studies in dogs 5 noted a similar significant decrease in systolic function (LV 1dP/dt) after the 1st dose of sotalol when compared with baseline.…”

Section: Discussionmentioning

confidence: 68%

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Acute echocardiographic effects of sotalol on ventricular systolic function in dogs with ventricular arrhythmias

Visser

Kaplan

Nishimura

et al. 2018

Veterinary Internal Medicne

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BackgroundSotalol is a commonly used antiarrhythmic drug that may alter ventricular function.ObjectiveTo determine the effect of sotalol on echocardiographic indices of ventricular systolic function in dogs with ventricular arrhythmias.AnimalsThirty‐five client‐owned dogs with ventricular arrhythmias.MethodsDogs with ventricular arrhythmias (n = 27) had an echocardiogram and 5‐minute ECG performed at baseline and 2‐4 hours post‐sotalol (2‐2.5 mg/kg PO once). Eight additional dogs underwent the same protocol but did not receive sotalol (within‐day variability controls). Left ventricular (LV) internal dimension at end‐systole normalized to bodyweight (LVIDs_N), LV ejection fraction (LV EF), LV shortening area, LV fractional shortening, tricuspid annular plane systolic excursion (TAPSE), and right ventricular systolic myocardial velocity were evaluated as indices of systolic function.ResultsAll indices except TAPSE had mild decreases in systolic function post‐sotalol (all P ≤ .0007) compared with baseline but only the percent change in LVIDs_N and LV EF were significantly (P ≤ .0079) different from the percent change of the same indices in control dogs. Sinus heart rate, ventricular premature complexes/5‐minutes, and arrhythmia grade also were decreased post‐sotalol (all P ≤ .01) compared with baseline when assessed by a 5‐minutes ECG. No dog experienced an adverse event post‐sotalol, including dogs with systolic dysfunction or atrial enlargement.Conclusions and Clinical ImportanceA single dose of sotalol may cause a mild decrease in LV systolic function in dogs with ventricular arrhythmias. Sotalol appears to be well tolerated, even in dogs with atrial enlargement or systolic dysfunction.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 71%

Acute echocardiographic effects of sotalol on ventricular systolic function in dogs with ventricular arrhythmias

Visser

Kaplan

Nishimura

et al. 2018

Veterinary Internal Medicne

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“…Although a small study, Singh et al 52 (1989) performed the first trial to study the efficacy of sotalol in treating ventricular premature complexes (PVC) in 24 patients with normal and reduced EF, defined as ≥ 40% and <40%, respectively. The EF was evaluated by performing radionucleotide ventriculography in each patient before and after treatment with sotalol.…”

Section: Previous Trials On Sotalol Use In Heart Failurementioning

confidence: 99%

The Arrhythmogenicity of Sotalol and its Role in Heart Failure: A Literature Review

Augustin

Alvarez

Kluger

2023

Journal of Cardiovascular Pharmacology

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According to the American Heart Association, approximately 6 million adults have been afflicted with heart failure in the United States in 2020 and are more likely to have sudden cardiac death accounting for approximately 50% of the cause of mortality. Sotalol is a nonselective β-adrenergic receptor antagonist with class III antiarrhythmic properties that has been mostly used for atrial fibrillation treatment and suppressing recurrent ventricular tachyarrhythmias. The use of sotalol in patients with left ventricular dysfunction is not recommended by the American College of Cardiology or American Heart Association because studies are inconclusive with conflicting results regarding safety. This article aims to review the mechanism of action of sotalol, the β-blocking effects on heart failure, and provide an overview of clinical trials on sotalol use and its effects in patients with heart failure. Small- and large-scale clinical trials have been controversial and inconclusive about the use of sotalol in heart failure. Sotalol has been shown to reduce defibrillation energy requirements and reduce shocks from implantable cardioverter-defibrillators. Torsades de Pointes is the most life-threatening arrhythmia that has been documented with sotalol use and occurs more commonly in women and heart failure patients. Thus far, mortality benefits have not been demonstrated with sotalol use and larger multicenter studies are required going forward.

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