Safety and efficacy of sotalol in patients with drug-refractory sustained ventricular tachyarrhythmias

Kehoe, Richard F.; Zheutlin, Terry; Dunnington, Cathy S.; Mattioni, Thomas A.; Yu, George W.; Spangenberg, Robert

doi:10.1016/0002-9149(90)90204-e

Cited by 57 publications

(21 citation statements)

References 15 publications

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“…This is comparable to the 80% arrhythmia-free survival at 12 months in the ESVEM trial [17] . This is also comparable to a non-randomized study of sotalol in which ventricular tachyarrhythmia was prevented in 76% at 12 months [18] . In our study amiodarone prevented ventricular tachyarrhythmia recurrence in 69% at 12 months, and in 43% at 36 months.…”

Section: Efficacy Of Sotalol and Amiodarone In Preventing Recurrence supporting

confidence: 79%

“…Adverse effects caused withdrawal of sotalol in 7%-22% of patients in other studies [18,40,41] . Amiodarone induced adverse effects requiring withdrawal of therapy in 32%-35% of patients in other studies [42,43] .…”

Section: Poor Tolerance Of Sotalol and Amiodaronementioning

confidence: 83%

“…A death rate of 4% has been reported with sotalol when used to treat patients with sustained ventricular tachyarrhythmia at a mean follow up of 346 days [18] . In the ESVEM study mortality from arrhythmia in patients treated with sotalol was 15% at 3 years [17] .…”

Section: Efficacy Of Sotalol and Amiodarone In Preventing Death From mentioning

confidence: 99%

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Comparison of sotalol with amiodarone for long-term treatment of spontaneous sustained ventricular tachyarrhythmia based on coronary artery disease

Kovoor

Eipper

Cooper

et al. 1999

European Heart Journal

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Aim To compare the efficacy of sotalol versus amiodarone for long-term treatment of ventricular tachyarrhythmias.Methods Patients (n=75) with spontaneous, sustained ventricular tachyarrhythmias secondary to remote myocardial infarction were studied. After intravenous electrophysiological testing, both sotalol and amiodarone were predicted to be ineffective in 50 (67%) patients. Five patients were excluded. Forty-five patients were randomized to receive sotalol (n=22) or amiodarone (n=23) for maintenance therapy. The primary outcome variable was the time to first recurrence of sustained ventricular tachyarrhythmia.Results At 36 months, 75% of those allocated sotalol remained free of ventricular tachyarrhythmia compared with 38% of those allocated amiodarone (P=0·05). On multivariate analysis the risk of recurrence of ventricular tachyarrhythmia for patients on amiodarone was 5·9 times higher (P=0·008) than that for patients on sotalol.Conclusion Sotalol is superior to amiodarone for longterm treatment of ventricular tachyarrhythmia secondary to coronary artery disease when both drugs have been predicted to be ineffective at intravenous electrophysiological testing. Randomized trials in larger numbers of patients with ventricular tachyarrhythmia need to be performed comparing the two agents directly. (Eur Heart J 1999; 20: 364-374)

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Section: Efficacy Of Sotalol and Amiodarone In Preventing Recurrence supporting

confidence: 79%

Section: Poor Tolerance Of Sotalol and Amiodaronementioning

confidence: 83%

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Comparison of sotalol with amiodarone for long-term treatment of spontaneous sustained ventricular tachyarrhythmia based on coronary artery disease

Kovoor

Eipper

Cooper

et al. 1999

European Heart Journal

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“…Most patients have no significant decrease in left ventricular ejection fraction while taking sotalol. However, sotalol can exacerbate heart failure in some patients (1% to 3%) with compromised left ventricular function, and therefore needs to be used with caution in patients with moderate to severe heart failure [24,26,28].…”

Section: Sotalol (Betapace and Betapace Af [Berlex Laboratories Waynmentioning

confidence: 99%

Antiarrhythmic drug therapy

Triola

Kowey²

2006

Curr Treat Options Cardio Med

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The use of antiarrhythmic drugs can be challenging to physicians. They are effective in treating various types of arrhythmias, yet their potential to cause adverse events, in particularly proarrhythmia, can be intimidating. When the decision to use antiarrhythmic therapy has been made, physicians are confronted with several issues: choosing the right drug, preventing complications, and selecting the setting in which the drug is to be given (in-hospital vs outpatient). In determining the best antiarrhythmic agent for each patient, one should have a basic understanding of their mechanisms of action and indications. Once this decision has been made, attention turns to avoiding complications and assessing for efficacy. Clinicians should be aware of the common drug interactions of each antiarrhythmic agent and avoid these whenever possible. In addition, patients need meticulous follow-up, including serial electrocardiograms and assessment for cardiovascular side effects. For several of the antiarrhythmic drugs, this can be accomplished in the outpatient setting in appropriate patients.

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“…Although there is a plethora of data on the antiarrhythmic action of sotalol in various heart conditions [21][22][23][24][25][26][27][28][29][30], the drug has not been extensively studied in patients with HCM. In our group of patients, sotalol ap peared to be more effective than placebo in suppressing supraventricular arrhythmias.…”

Section: Antiarrhythmic Effectmentioning

confidence: 99%

Effect of Sotalol on Arrhythmias and Exercise Tolerance in Patients with Hypertrophic Cardiomyopathy

Tendera

Wycisk²,

Schneeweiss³

et al. 1993

Cardiology

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The effect of sotalol on exercise tolerance and incidence of arrhythmias was studied in 30 patients with hypertrophic cardiomyopathy (HCM). In this short-term, double-blind, crossover study, exercise time on sotalol (320 mg/day) was significantly longer than on placebo (10.6 ± 4.0 vs. 9.4 ± 3.6 min; p < 0.01). Sotalol eliminated supraventricular arrhythmias in 6 of 7 patients (p < 0.03) and suppressed ventricular arrhythmias in 7 of 13 patients in whom they were present on placebo (p < 0.05). Ventricular tachycardia was abolished in 4 of 8 patients, but appeared during sotalol treatment in 1 patient who was free of repetitive arrhythmias on placebo. Twenty-five patients who had better exercise tolerance on sotalol than on placebo and did not experience aggravation of arrhythmia entered a 6-month prospective, open-label treatment with sotalol (160-480 mg/day, mean ± SD377 ± 94). One patient was withdrawn after 1 month because of bronchospasm. Mean exercise time improved from 9.8 ± 3.6 min on placebo to 12.7 ± 3.2 min (p < 0.01) after 6 months of treatment with sotalol. During the prospective follow-up, sotalol abolished ventricular tachycardia in all 6 patients after 1 month (p = 0.022), and in 4 of 6 patients (p > 0.2) after 6 months of treatment. It is concluded that sotalol significantly improves exercise tolerance and is effective in suppressing both supraventricular and ventricular arrhythmias in patients with HCM.

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Safety and efficacy of sotalol in patients with drug-refractory sustained ventricular tachyarrhythmias

Cited by 57 publications

References 15 publications

Comparison of sotalol with amiodarone for long-term treatment of spontaneous sustained ventricular tachyarrhythmia based on coronary artery disease

Comparison of sotalol with amiodarone for long-term treatment of spontaneous sustained ventricular tachyarrhythmia based on coronary artery disease

Antiarrhythmic drug therapy

Effect of Sotalol on Arrhythmias and Exercise Tolerance in Patients with Hypertrophic Cardiomyopathy

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