| Usefulness of sotalol for life-threatening ventricular arrhythmias. | |
| | |
MedLine Citation:
|
PMID: 8346727 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Two trial designs have been used in evaluating sotalol in patients with sustained tachyarrhythmias: open-label dose escalation and randomized comparison with reference agents. At least 7 open-label studies (n = 16-65) have been reported from single centers in patients in whom trials of numerous other antiarrhythmic agents were unsuccessful. At the doses used, usually 320-640 mg/day, plasma concentrations were in the range associated with both beta blockade and class III antiarrhythmic activity (2-3 micrograms/mL). These concentrations produced electrophysiologic changes that were consistent across studies: 10-16% increase in right ventricular effective refractory period (ERP), 4-8% increase in corrected QT interval (QTc), and 17-30% increase in sinus cycle length (corresponding to a 15-23% decrease in heart rate). In these open-label trials, sotalol suppressed inducible ventricular tachyarrhythmias in 20-72% of patients; the higher degrees of efficacy were reported when induction protocols were confined to double extrastimuli. Side effects leading to discontinuation of sotalol in patients with sustained ventricular tachycardia or fibrillation include fatigue (4.0%), marked bradycardia (3.0%), torsades de pointes (3.0%), and heart failure or pulmonary edema (1.0%). A multicenter randomized trial compared intravenous sotalol with intravenous procainamide in a double-blind prospective fashion. Sotalol suppressed ventricular tachyarrhythmias inducible with triple extrastimuli in 15 (30%) of 50 patients, whereas procainamide was effective in 10 (20%) of 50. In this and other series, responsiveness to sotalol was prospectively identified by a particularly fast tachycardia at baseline (e.g., cycle length of < 270 msec), but not by the extent of changes in global indices of repolarization (QTc, ERP).(ABSTRACT TRUNCATED AT 250 WORDS) |
| | |
Authors:
|
D M Roden |
Related Documents
:
|
15036737 - Long-term subjective memory function in ventricular fibrillation out-of-hospital cardia... 10190407 - Placebo effect of pacemaker implantation in obstructive hypertrophic cardiomyopathy. pi... 2650517 - Efficacy and safety of intravenous diltiazem for treatment of atrial fibrillation and a... 1387287 - Short- and long-term efficacy and safety of flecainide acetate for supraventricular arr... 2176097 - Alkalinization of 0.5% lidocaine for intravenous regional anesthesia. 20339697 - Group therapy for patients with tinnitus at the university of brasilia medical school. |
Publication Detail:
|
Type: Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial |
Journal Detail:
|
Title: The American journal of cardiology Volume: 72 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1993 Aug |
Date Detail:
|
Created Date: 1993-09-09 Completed Date: 1993-09-09 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 51A-55A Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee 37232-6602. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Amiodarone / therapeutic use Anti-Arrhythmia Agents / adverse effects, therapeutic use* Arrhythmias, Cardiac / drug therapy* Female Humans Male Middle Aged Procainamide / therapeutic use Sotalol / adverse effects, therapeutic use* |
| Chemical | |
Reg. No./Substance:
|
0/Anti-Arrhythmia Agents; 1951-25-3/Amiodarone; 3930-20-9/Sotalol; 51-06-9/Procainamide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Clinical safety profile of sotalol in the treatment of arrhythmias.
Next Document: Safety and efficacy of oral sotalol for sustained ventricular tachyarrhythmias refractory to other a...