Abstract
In order to assess the antiarrhythmic efficacy of oral sotalol we studied 46 patients with sustained monomorphic ventricular tachycardia (n = 40) or ventricular fibrillation (n = 6) by programmed ventricular stimulation. All patients had coronary artery disease with a history of myocardial infarction. Prior to sotalol, patients were treated with a mean of 3.4 ± 1.4 antiarrhythmic Class I drugs. None of these drugs prevented sustained monomorphic ventricular tachycardia or ventricular fibrillation. During control programmed ventricular stimulation (PVS 1) ventricular fibrillation was induced in 7 patients (15%), sustained monomorphic ventricular tachycardia in 30 patients (65%), and nonsustained ventricular tachycardia in 9 patients (20%). After loading with oral sotalol (320 mg/day) programmed ventricular stimulation (PVS 2) was repeated 4.2 ± 3.3 weeks after PVS 1. Ventricular fibrillation was not inducible in any of the patients; in 10 patients (22%) sustained monomorphic ventricular tachycardia was induced, and nonsustained ventricular tachycardia was induced in 10 patients (22%). In 26 patients (57%) either no response or a short ventricular response was inducible. Our data show that oral sotalol is an effective antiarrhythmic agent in patients with sustained monomorphic ventricular tachycardia or ventricular fibrillation following myocardial infarction.
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