| Effects of Sotalol on His-Purkinje Conduction and Refractoriness in Humans. | |
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MedLine Citation:
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PMID: 10684394 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The effects of sotalol on refractoriness in human ventricular and atrial muscles have been well established, but the drug's effect on the electrical properties of the His-Purkinje system in humans is not known, especially whether sotalol's effect is due solely to its action on prolonging repolarization or in combination with its beta-blocking properties. We studied the electrophysiologic effects of intravenous sotalol and propranolol in patients undergoing electrophysiologic studies of cardiac arrhythmias. METHODS AND RESULTS: We studied 22 patients (19 men, 3 women; mean age, 60 +/- 6 years) who had coronary artery disease and assessable anterograde, retrograde, or both, His-Purkinje system function. Fifteen patients underwent electrophysiologic studies before and after intravenous sotalol (1.5 mg/kg), and 7 patients underwent electrophysiologic studies before and after intravenous propranolol (0.15 mg/kg). Both sotalol and propranolol had no significant effect on the H-V interval, but sotalol significantly increased ventricular refractoriness and His-Purkinje refractoriness, both in anterograde and retrograde conduction, whereas propranolol did not, Sotalol's effect on His-Purkinge refractoriness also caused atrioventricular block distal to the His bundle during atrial pacing at a moderately fast rate. Sotalol was not effective in preventing bundle branch re-entry tachycardia, nevertheless, it increased cycle length of bundle branch re-entry tachycardia by increasing refractoriness. CONCLUSIONS: Sotalol increased His-Purkinje refractoriness in humans but had no effect on His-Purkinje conduction. The drug must be used judiciously in patients with a diseased His-Purkinje system because it may cause atrioventricular block distal to His at fast heart rates. Sotalol had no effect on macrore-entry utilizing bundle branches. |
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Authors:
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Nademanee; Noll; Feld |
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Publication Detail:
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Type: JOURNAL ARTICLE; JOURNAL ARTICLE |
Journal Detail:
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Title: Journal of cardiovascular pharmacology and therapeutics Volume: 1 ISSN: 1940-4034 ISO Abbreviation: J. Cardiovasc. Pharmacol. Ther. Publication Date: 1996 Jan |
Date Detail:
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Created Date: 2000-02-22 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9602617 Medline TA: J Cardiovasc Pharmacol Ther Country: - |
Other Details:
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Languages: ENG Pagination: 9-16 Citation Subset: - |
Affiliation:
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Department of Cardiology, Sharp Rees-Stealy Medical Group, Los Angeles, California, USA |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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