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European Heart Journal 1993 14(Supplement H):85-87; doi:10.1093/eurheartj/14.suppl_H.85
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Acute and chronic antiarrhythmic efficacy of d-sotalol in patients with sustained ventricular tachyarrhythmias

J. Brachmann, W. Schöls, T. Beyer, M. Montero, B. Enders and W. Kübler

Medical University Hospital, Department of Cardiology Heidelberg, Germany

Correspondence: J. Brachmann, MD, Med. Univ. Klinik, Dep. Internal Medicin III, Cardiology, Bergheimer Str. 58,6900 Heidelberg, Germany

To evaluate the clinical efficacy of d-sotalol, 84 patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF), who had inducible sustained VT/VF at baseline electrophysiologic study (EPS), were investigated after intravenous (IV) d-sotalol (1.5-2.5 mg.kg–1). A total of 29 additional patients received only oral d-sotalol (400–600 mg.day–1). Acute success of antiarrhythmic therapy was defined as suppression of inducible sustained VT/VF. The overall success rate of IV d-sotalol was 38% (32/84) after a mean of 4.3 drugs failed to suppress inducibility. A 78% success rate 31/40) was demonstrated in patients who were also assessed after oral d-sotalol. Torsade de pointes type VT was seen in one tatient. After 1 year, only 16% of patients with a positive EPS had a recurrence compared to 43% of patients with a negaive EPS (P < 0.05). Estimated survival rates were 95 and 88% after 1 and 2 years of follow-up, respectively. Only five of 56 latients discontinued d-sotalol therapy because of adverse effects. IV d-sotalol appears to be an effective antiarrhythmic agent. Its long-term efficacy is predictable on the basis of therapy guided by electrophysiologic testing in patients with refractory ventricular tachyarrhythmias. The efficacy of d-sotalol seems comparable to that reported for d,l-sotalol.

Key Words: d-Sotalol • ventricular tachyarrhythmias • programmed electrical stimulation (PES)


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