Circulation, Vol 75, 1050-1057, Copyright © 1987 by American Heart Association
KP Kunze, M Schluter and KH Kuck
We evaluated the effects of intravenous and long-term oral sotalol
treatment in 17 patients with an accessory atrioventricular (AV) pathway.
All patients had a history of symptomatic supraventricular tachycardia.
During electrophysiologic study intravenous (1.5 mg/kg body weight) and
oral (240 to 320 mg/day) sotalol caused significant increases of sinus
cycle length, AV nodal conduction time, and refractory periods of atrial
and ventricular myocardium and accessory pathway. AV reciprocating
tachycardia, which was inducible and sustained in 15 patients at control,
was still inducible after intravenous sotalol in 14 patients, including one
in whom it was not inducible at control. However, tachycardia became
nonsustained in 10 patients. In seven patients who underwent repeat drug
testing while on oral sotalol, results were the same as after intravenous
sotalol. Sixteen patients were followed-up for 36 months (median value).
Fifteen of them were clinically free of symptoms or experienced marked
improvement, despite recurrences of tachycardia in two. In a third patient
sotalol had to be withdrawn because of recurrent supraventricular
tachycardia. Orthostatic hypotension occurred in five patients and required
withdrawal of sotalol in one. To predict the long- term clinical outcome of
patients, exercise testing and Holter monitoring were of little or no
value. Programmed electrical stimulation predicted clinical outcome in 63%
after intravenous and in 86% after oral sotalol. This study shows that
long-term treatment with sotalol is highly effective in patients with the
Wolff-Parkinson-White syndrome and regular supraventricular tachycardia.
ARTICLES
Sotalol in patients with Wolff-Parkinson-White syndrome
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