FOCUS ON SOTALOL - A CLASS-III ANTIARRHYTHMIC AGENT WITH BETA-BLOCKING ACTIVITY

Sotalol is a new class III antiarrhythmic agent with beta-receptor blocking activity. Its cardiac effects include decrease in heart rate and blood pressure, as well as lengthening of cardiac repolarization and action potential duration, resulting in QT prolongation on a surface electrocardiogram. Sotalol is very well absorbed and mainly eliminated through glomerular filtration. The elimination half-life is around 7 hours. Sotalol effectively prevents recurrences of atrial fibrillation after cardioversion and recurrences of ventricular tachycardia and fibrillation, as well as converts paroxysmal supraventricular tachycardia to sinus rhythm. Adverse effects associated with sotalol are related to its beta-blocking activity and its electrophysiologic properties, and include fatigue, dyspnea, bradycardia, worsening of congestive heart failure, and proarrhythmia. Overall, sotalol is a unique antiarrhythmic agent and may be a useful addition to formularies in the future.