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Sotalol vs metoprolol for ventricular rate control in patients with chronic atrial fibrillation who have undergone

G E Kochiadakis1, E M Kanoupakis, M D Kalebubas

  • 1Cardiology Department, Heraklion University Hospital, P.O. Box 1352, Stavrakia Heraklion, Crete, Greece.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|March 29, 2001
PubMed

Insights

Sotalol and metoprolol effectively lower heart rate in patients with chronic atrial fibrillation. Sotalol demonstrated superior heart rate control during submaximal exercise and daily activities compared to metoprolol.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Chronic atrial fibrillation (AF) management requires effective heart rate control.
  • Digitalized patients with AF often present challenges in optimizing therapeutic interventions.

Purpose of the Study:

  • To compare the efficacy of sotalol versus metoprolol in controlling heart rate.
  • To assess heart rate responses during various activity levels, including isotonic exercise, isometric exercise, and daily life, in digitalized patients with chronic AF.

Main Methods:

  • A randomized, single-blinded, crossover study involving 23 patients with chronic AF.
  • Patients received placebo, sotalol, and metoprolol for 4-week periods.
  • Assessments included 24-hour ECG monitoring, cardiopulmonary exercise testing, and isometric handgrip maneuvers.

Main Results:

  • Both sotalol and metoprolol significantly reduced heart rate at rest and during isotonic exercise compared to placebo.
  • Sotalol showed a significantly lower heart rate than metoprolol during submaximal exercise and isometric exercise.
  • Sotalol also achieved a lower mean heart rate during daytime activities compared to metoprolol.

Conclusions:

  • Sotalol is a safe and effective option for heart rate control in digitalized patients with atrial fibrillation.
  • Sotalol offers superior heart rate control during submaximal exercise and daily activities compared to metoprolol.
Abstract

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