Antiarrhythmic Efficacy of Oral Sotalol in Patients with Sustained Ventricular Tachycardia or Ventricular Fibrillation Postmyocardial Infarction

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.