The advantage of d-sotalol over dl-sotalol in a patient with ventricular arrhythmias and comorbid bronchospasm.
The anti-arrhythmic agent sotalol, a racemic mixture of d- and l-isomers, has inherent beta-adrenoceptor blocking activity due to the l-isomer form. For patients with contraindications to beta-adrenoreceptor blockade, dl-sotalol has potentially untoward effects that may limit its usefulness. The case of a man with resistant life-threatening ventricular arrhythmias who responded favorably to dl-sotalol, but developed worsening of underlying bronchospastic lung disease, is presented. A change in therapy to the d-isomer form of sotalol, d-sotalol, was effective in suppressing his ventricular arrhythmias without further aggravation of bronchospasm.
Kuntz
R E
RE
Charles A. Dana Research Institute, Beth Israel Hospital, Boston 02215.
Ruskin
J N
JN
Weinberger
S
S
Lorell
B H
BH
D001986:Bronchial Spasm / Q000150:complications*; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications; D008297:Male; D008875:Middle Aged; D013015:Sotalol / Q000627:therapeutic use*; D013237:Stereoisomerism; D013575:Syncope / Q000209:etiology; D017180:Tachycardia, Ventricular / Q000150:complications / Q000188:drug therapy*
D013015:Sotalol