[Suicide attempt with sotalol: a proarrhythmic intoxication]

A 62-year-old man was brought into the intensive care unit because of a cardiac arrest. After extensive resuscitation, including defibrillation, sinus bradycardia occurred with marked QT prolongation, followed by recurrent episodes of torsade de pointes. Hetero-anamnestic data revealed a suicide attempt with sotalol. Treatment consisted largely of temporary pacing using an external transvenous overdrive pacemaker and administration of glucagon, milrinon and norepinephrine. Eventually, the patient was discharged in good condition. A suicide attempt with sotalol is a rare intoxication with considerable morbidity and mortality. Treatment is primarily based upon counteracting the proarrhythmic effects of sotalol. However, even when therapeutic levels of this drug are used, proarrhythmic effects can occur.