Gold Coast Hospital and Health Service, Southport, Queensland, Australia.
School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
Am J Ther. 2019 Jan/Feb;26(1):e161-e169. doi: 10.1097/MJT.0000000000000507.
Despite proven effectiveness in treating tachyarrhythmias, sotalol is proarrhythmic and can cause torsades de pointes. Given the emergence of studies that show no benefit from rhythm control strategies in managing atrial fibrillation, as well as the introduction of nonpharmacological approaches to treating arrhythmias, we felt it necessary to ascertain if there was any role for sotalol given its side effects. Review of the literature regarding sotalol use in the prevention and treatment of supraventricular and ventricular tachyarrhythmias seems to show that more effective and safer agents and nonpharmacological alternatives are currently available. However, sotalol still seems to be useful in preventing supraventricular tachyarrhythmias postcardiac surgery and in reverting hemodynamically stable sustained ventricular tachycardias in the setting of coronary artery disease. Its role in the prevention of tachyarrhythmias in the setting of arrhythmogenic right ventricular cardiomyopathy requires further investigation.
尽管索他洛尔在治疗快速性心律失常方面已被证实有效，但它有致心律失常作用，可引起尖端扭转型室性心动过速。鉴于一些研究表明节律控制策略在管理心房颤动方面没有益处，以及非药物治疗心律失常方法的出现，我们认为有必要确定索他洛尔是否因其副作用而具有一定作用。对文献进行回顾，了解索他洛尔在预防和治疗室上性和室性快速性心律失常方面的应用，似乎表明目前有更有效和更安全的药物和非药物替代方法。然而，索他洛尔在预防心脏手术后室上性快速性心律失常和逆转冠状动脉疾病患者血流动力学稳定的持续性室性心动过速方面似乎仍然有用。它在致心律失常性右心室心肌病患者中预防快速性心律失常的作用需要进一步研究。
