Usefulness of d, I sotalol for suppression of chronic ventricular arrhythmias.

Abstract

Sotalol is a unique beta-blocking drug, possessing significant class III antiarrhythmic activity. The efficacy and safety of 2 doses of sotalol (320 and 640 mg/day, divided in 2 doses) were compared to placebo in a 6-week randomized, double-blind, multicenter study of 114 patients with chronic ventricular premature complexes (VPCs) at frequencies of greater than or equal to 30/hour. Sotalol significantly reduced VPCs in patients receiving both low (n = 38) and high (n = 39) doses, compared with patients (n = 37) receiving placebo (by 75 and 88%, respectively, vs 10%; p less than 0.001, sotalol vs placebo; p less than 0.05, high vs low dose). The individual efficacy criterion (greater than or equal to 75% VPC reduction) was achieved in 34% of low-dose and 71% of high-dose sotalol versus 6% of placebo-treated patients (p less than 0.003, sotalol vs placebo; p = 0.007, high vs low dose). Repetitive beats were suppressed 25% by placebo (difference not significant), 80% by low-dose (p less than 0.003) and 78% by high-dose sotalol (p less than 0.005). Sotalol decreased heart rate (by 24 to 25%, p less than 0.001) and increased PR (by 4 to 6%, p less than 0.001) and corrected JT intervals (by 12 to 13%, p less than 0.001), but did not change ejection fraction. Proarrhythmia (nonfatal) occurred in 3 sotalol and in 2 placebo patients. Nine discontinued therapy because of adverse effects (1 low dose and 8 high dose, p less than 0.02). In summary, sotalol is an efficacious antiarrhythmic drug for VPC suppression; in lower doses, it is somewhat less effective but better tolerated.

• Authors: M I Anastasiou-Nana, E M Gilbert, R H Miller, S Singh, R A Freedman, D L Keefe, S Saksena, D J MacNeil, J L Anderson
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 67 Issue 6 Pg. 511-6 (Mar 01 1991) ISSN: 0002-9149 [Print] United States
• PMID: 1705386 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Sotalol

Topics

• Adult
• Aged
• Arrhythmias, Cardiac (drug therapy, physiopathology)
• Cardiac Complexes, Premature (drug therapy, physiopathology)
• Chronic Disease
• Circadian Rhythm
• Double-Blind Method
• Electrocardiography, Ambulatory
• Female
• Heart Ventricles (physiopathology)
• Humans
• Male
• Middle Aged
• Single-Blind Method
• Sotalol (administration & dosage, adverse effects, therapeutic use)
• Stroke Volume (drug effects)