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Related Experiment Videos

Sotalol-induced torsade de pointes.

P Rakovec, B Cercek, P Rode

    Catheterization and Cardiovascular Diagnosis
    |January 1, 1984
    PubMed
    Summary

    Sotalol can cause Torsade de Pointes, a type of ventricular tachycardia, especially in patients with pre-existing prolonged Q-T intervals. Pindolol did not induce this arrhythmia in the patient.

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    Area of Science:

    • Cardiology
    • Pharmacology
    • Electrophysiology

    Background:

    • Sotalol is a beta-blocker with Class III antiarrhythmic properties.
    • Polymorphous ventricular tachycardia, specifically Torsade de Pointes (TdP), is a known adverse effect of drugs prolonging the Q-T interval.
    • The patient presented with a moderately prolonged Q-T interval prior to sotalol initiation.

    Observation:

    • Sotalol administration led to further Q-T interval prolongation.
    • The patient experienced episodes of ventricular tachycardia.
    • Electrophysiological study during sotalol rechallenge showed a uniform ventricular tachycardia with a polymorphic onset.

    Findings:

    • Sotalol precipitated Torsade de Pointes in a patient with a pre-existing prolonged Q-T interval.
    • The electrophysiological study results were suggestive but not definitively conclusive for replicating the spontaneous arrhythmia.
    • Ventricular tachycardia was not inducible when the patient was on pindolol and not on antiarrhythmic drugs.

    Implications:

    • This case highlights the risk of sotalol-induced Torsade de Pointes, emphasizing the importance of baseline Q-T interval assessment.
    • It underscores the need for careful monitoring of Q-T interval and cardiac rhythm in patients receiving sotalol.
    • The findings suggest that alternative antiarrhythmic agents like pindolol may be safer in susceptible individuals.

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