Safety and efficacy of oral sotalol for sustained ventricular tachyarrhythmias refractory to other antiarrhythmic agents

Kehoe, Richard F.; MacNeil, Daniel J.; Zheutlin, Terry; Ezri, Marilyn D.; Nazari, Jose; Spangenberg, Robert; Dunnington, Catherine; Lueken, Mark

doi:10.1016/0002-9149(93)90026-9

Cited by 43 publications

(14 citation statements)

References 16 publications

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“…Seventy per cent of the patient population of this study were the cases with sustained ventricular tachycardia, with a low prevalence (7%) of patients with aborted sudden death. This patient population is, therefore, quite different from the population enrolled in other studies dealing with ICD treatment [4,-6,26,28] or exclusively with patients with aborted sudden death [1] or dealing with primary prevention of sudden death in coronary artery disease patients at high risk [24,27] . Thus, the clinical profile of the patients enrolled in this study is similar to that of patients enrolled in the studies by Steinbeck et al [2] , by Haverkamp et al [19] and in the ESVEM study [3,11] .…”

Section: Discussionmentioning

confidence: 94%

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A multicentre, double-blind randomized crossover comparative study on the efficacy and safety of dofetilide vs sotalol in patients with inducible sustained ventricular tachycardia and ischaemic heart disease

Boriani

Lubiński²,

Capucci³

et al. 2001

European Heart Journal

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Background Antiarrhythmic drugs are still used for the treatment of ventricular tachyarrhythmias, in combination with implantable cardioverter-defibrillators or without them.Aim of the study In a double-blind randomized crossover design, the short-and long-term efficacy and safety of oral dofetilide or oral sotalol were compared in 135 patients with ischaemic heart disease and inducible sustained ventricular tachycardia. MethodsThe inducibility of ventricular tachycardia was determined by programmed electrophysiological stimulation at baseline. Patients were then blindly randomized to receive either oral dofetilide 500 g twice daily or oral sotalol 160 mg twice daily, for 3 to 5 days. Suppression of inducible ventricular tachycardia on the drug was then assessed by programmed electrophysiological stimulation. After a wash-out period of at least 2·5 days, the patients received the alternative treatment for 3 to 5 days. Suppression of inducible ventricular tachycardia on the alternate drug was again determined by programmed electrophysiological stimulation. Selection of long-term treatment was allocated blindly according to programmed electrophysiological stimulation results.Results During the acute phase, 128 patients received both dofetilide and sotalol. Sixty-seven patients were responders to either drug. Forty-six patients (35·9%) were responders to dofetilide compared with 43 (33·6%) to sotalol (P=ns). Only 23 patients responded to both dofetilide and sotalol. Adverse events, deemed to be treatment related, were seen in 2·3% of patients receiving dofetilide and 8·6% of patients receiving sotalol (P=0·016). Three patients on dofetilide had torsade de pointes. Two patients receiving sotalol died during the acute phase (one was arrhythmic death, and the other was due to heart failure). During the long-term phase, two of 42 patients (4·8%) receiving dofetilide and three of 27 patients (11·1%) receiving sotalol withdrew from treatment due to lack of efficacy. Overall, during the long-term phase, 23·8% of the patients receiving dofetilide and 37·0% of the patients receiving sotalol, withdrew from treatment with a similar pattern of withdrawals for the two drugs.Conclusion Dofetilide was as efficacious as sotalol in preventing the induction of sustained ventricular tachycardia. There was no concordance in the response rate in two-thirds of the patients. Dofetilide was significantly better tolerated during the acute phase than sotalol. Both dofetilide and sotalol were well tolerated during the long term with no statistically significant difference in the adverse events.

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Section: Discussionmentioning

confidence: 94%

“…Steinbeck et al [2] , 1992 Kehoe et al [24] , 1993 473 Pacifico et al [26] , 1999 302 with ICD R to sotalol (151) or placebo (151) Prior MI in 66-73%…”

Section: Dofetilide Vs Sotalol In Isvt and Ihd 2187mentioning

confidence: 99%

A multicentre, double-blind randomized crossover comparative study on the efficacy and safety of dofetilide vs sotalol in patients with inducible sustained ventricular tachycardia and ischaemic heart disease

Boriani

Lubiński²,

Capucci³

et al. 2001

European Heart Journal

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show abstract

“…Sotalol is safe and generally well tolerated; most of the adverse effects experienced with its use are related to its /^-blocking activity. However, sotalol has been associated with life-threatening proarrhythmias, including torsade de pointes, although the incidence of this adverse effect is low, varying between 1.8 and 3% in the clinical trials conducted to date [1][2][3]. To our knowledge, the occurrence of sotalol-induced torsade de pointes has never been reported before in haemodialysis (HD) patients.…”

Section: Introductionmentioning

confidence: 97%

Torsade de pointes during low-dosage sotalol therapy in haemodialysis patients

Huynh-Do¹,

Wahl²,

Sulzer³

et al. 1996

Nephrology Dialysis Transplantation

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“…Sotalol has been previously implicated as a cause of torsades de pointes. Kehoe et al reported 481 patients on sotalol of whom 31 (6.4%) developed some pro‐arrhythmia of which 15 (3.1%) were torsades de pointes 16 . MacNeil et al in their meta‐analysis of 3257 patients on sotalol reported torsades de pointes as occurring in 78 (2.4%) 17 .…”

Section: Discussionmentioning

confidence: 99%