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European Heart Journal 1990 11(1):35-42;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Electrophysiological effects of intravenous sotalol in acute myocardial infarction: A double-blind placebo-controlled study

M A{ring}STRÖM, O. EDHAG, O. NYQUIST and H. VALLIN

Cardiac Division, Karolinska Institute, Huddinge Hospital Huddinge, Sweken

Received 19 July 1988; revised 16 June 1989; .

Mat S A{ring}ström,M.D., Department of Medicine, Huddginge Hospital, S-141 86 Huddinge, Sweden

Abstract

Controlled studies of the electrophysiological effects of beta-blockade in acute myocardial infarction have not previously been published. In this controlled, double-blind study 20 patients were randomized to treatment with placebo or sotalol administered as a continuous infusion for 12 h. Programmed electrical stimulation was performed from the right atrium.After 60 min of infusion in the sotalol-treated patients (n=10) there was a significant prolongation of sinus cycle length (+15%) and sinus node recovery time (+28%). The AV nodal effective refractory period was prolonged by 15% after 45 min of infusion. Variables reflecting myocardial repolarization, atrial effective refractory period and Q T interval, were increased by 20% and 10%, respectively.In the placebo group, except at 12 h, there was a general pattern of slightly diminishing values for all measured variables.The electrophysiological changes in the sotalol-treated group could be explained by the combined Class II and III activities of this drug. The infusion of sotalol was well tolerated, and the anticipated electrophysiological and Class II and III antiarrhythmic effects were observed, despite the acute myocardial infarction.

Key Words: Electrophysiology • sotalol • acute myocardial infarction


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