title: Sotalol: a rescue drug in the face of life-threatening refractory ventricular tachycardia.
abstract: We describe postoperative refractory ventricular tachycardia (VT) in a patient following aortic and mitral valve replacement. Following an uneventful separation from cardiopulmonary bypass with dobutamine, the patient developed recurrent VT, 4 hours into the postoperative period. The VT did not respond to standard doses of xylocard, magnesium and amiodarone. Electrolyte and acid base parameters were normal. Multiple cardioversions failed to revert back to a stable rhythm. Intra-aortic balloon pumping was instituted and overdrive right ventricular pacing was unsuccessful. Following intravenous sotalol 80 mg, the VT came under control and reverted to a nodal rhythm, which required atrial pacing for the next 8 hours. Oral sotalol therapy was continued at 40 mg daily. The VT did not recur.
authors.affiliation: Department of Cardiothoracic Anesthesia, SRM Medical College Hospital and Research Centre, SRM University, Chennai, Tamil Nadu, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kandasamy
authors.forename: Sukumar
authors.initials: S
authors.lastname: Arumugham
authors.forename: Harshavardhan
authors.initials: H
authors.lastname: Krupanandha
authors.forename: Bhaktavatsala
authors.initials: B
authors.lastname: Reddy
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D004351:Drug Resistance; D004452:Echocardiography; D004562:Electrocardiography; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy; D013015:Sotalol / Q000627:therapeutic use*; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol