Sotalol offers broad antiarrhythmic efficacy

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IN BRIEFSotalol may be the class III antiarrhythmic of choice for patients with life-threatening ventricular arrhythmias in whom β-blockade is not contraindicated. The β-blocking action of the drug also makes it suitable for patients with arrhythmias and coexisting angina, hypertension or previous myocardial infarction.Sotalol is effective in preventing the recurrence of life-threatening ventricular arrhythmias, including those refractory to other drug therapy. In addition, the drug is more effective than class I antiarrhythmics in suppressing ventricular tachycardia and ventricular fibrillation.Sotalol appears to be at least as effective as conventional β-blockers in patients with supraventricular tachyarrhythmias after coronary artery bypass grafting. Despite this, the risk of torsade de pointes may render treatment with sotalol unacceptable in patients with relatively benign supraventricular arrhythmias.1However, sotalol is suitable for the acute termination of re-entrant supraventricular tachycardias in patients with relatively well preserved left ventricular function.

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