Results of sotalol (Darob) therapy in supraventricular tachyarrhythmias

The benefit of sotalol therapy in atrial flutter and in atrial fibrillation was considered, aiming as well the suppression of paroxysmal episodes and the prevention of their recurrencies and the control of the ventricular rhythm in chronic cases. The prospective study comprises 60 patients institutionalized in the Cardiology Clinic in which the supraventricular tachyarrhythmia range included: atrial flutter (20 cases) and atrial fibrillation (40 cases), from which atrial fibrillation of recent onset (20 cases) and chronic atrial fibrillation with fast ventricular response (20 cases). Sotalol was administered orally in doses of 80 to 320 mg daily, b.i.d. The conversion to sinus rhythm was obtained in 45% of cases of atrial fibrillation of recent onset and in 30% of cases of atrial flutter. The prophylactic administration of sotalol on long term (6 months), in medium dose of 160 mg daily, may protect against the recurrence of the supraventricular arrhythmias (63.85%). As adverse effect, a case of "torsade des pointes" was recorded.

1) a greater benefit was noticed by using sotalol prophylactically for the recurrence of the supraventricular arrhythmias (63.85%) compared to the positive results in the therapy of acute cases (37.5%); 2) the maximal efficiency in the prevention of arrhythmia recurrencies can be observed in patients that present underlying compensated ischemic cardiopathy; 3) a decrease of 30% of the ventricular rhythm in patients with atrial fibrillation was obtained.