Haemodynamic effects of intravenous sotalol in acute myocardial infarction

There are few placebo controlled studies in acute myocardial infarction concerning the haemodynamic effects of beta blockade. In a controlled, double-blind randomized study, the haemodynamic effects of sotalol were evaluated in 20 patients with acute myocardial infarction within 24 hours of the onset. Sotalol was administered to 10 patients over 12 hours by a continuous infusion including three different infusion rates. A serum level around 1.4 microgram ml-1 was achieved after one hour of infusion. The placebo patients were given saline infusion. The patients were monitored invasively using a thermodilution catheter in the pulmonary artery. In the sotalol group, there was a significant reduction in heart rate, systolic blood pressure, cardiac output and stroke volume compared to placebo. A slight increase in the mean pressures of right atrium, pulmonary artery systolic and diastolic pressures was also seen. The infusion was well tolerated and no adverse reaction was seen.