title: Does Sotalol Still Have a Role in the Management of Arrhythmias?
abstract: Despite proven effectiveness in treating tachyarrhythmias, sotalol is proarrhythmic and can cause torsades de pointes. Given the emergence of studies that show no benefit from rhythm control strategies in managing atrial fibrillation, as well as the introduction of nonpharmacological approaches to treating arrhythmias, we felt it necessary to ascertain if there was any role for sotalol given its side effects. Review of the literature regarding sotalol use in the prevention and treatment of supraventricular and ventricular tachyarrhythmias seems to show that more effective and safer agents and nonpharmacological alternatives are currently available. However, sotalol still seems to be useful in preventing supraventricular tachyarrhythmias postcardiac surgery and in reverting hemodynamically stable sustained ventricular tachycardias in the setting of coronary artery disease. Its role in the prevention of tachyarrhythmias in the setting of arrhythmogenic right ventricular cardiomyopathy requires further investigation.
authors.affiliation: Gold Coast Hospital and Health Service, Southport, Queensland, Australia.|School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Sahan P
authors.initials: SP
authors.lastname: Semasinghe Bandaralage
authors.affiliation: School of Medicine, Griffith University, Gold Coast, Queensland, Australia.|School of Medical Science, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Selvanayagam
authors.initials: S
authors.lastname: Nirthanan
authors.affiliation: Gold Coast Hospital and Health Service, Southport, Queensland, Australia.|School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: Selvanayagam
authors.initials: S
authors.lastname: Niranjan
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019571:Arrhythmogenic Right Ventricular Dysplasia / Q000150:complications; D001281:Atrial Fibrillation / Q000188:drug therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D006801:Humans; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods; D013015:Sotalol / Q000009:adverse effects* / Q000627:therapeutic use; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D016171:Torsades de Pointes / Q000139:chemically induced*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D013015:Sotalol