Brachmann J, Senges J, Lengfelder W, Jauernig R, Rizos I, Czygan E, Cobbe S M, Kübler W
Eur Heart J. 1985 Nov;6 Suppl D:171-4. doi: 10.1093/eurheartj/6.suppl_d.171.
Eighteen patients with sustained ventricular tachycardia underwent serial electrophysiological studies to establish the therapeutic efficacy of sotalol as compared to other available anti-arrhythmic agents. One or more acutely effective drug was found in 14 of the 18 patients (78%). Sotalol was tested in all 18 patients and was effective in 12 of them (67%). For assessment of the prophylactic efficacy of other anti-arrhythmic agents, an average of 3.5 additional studies per patient were performed resulting in successful prevention of ventricular tachycardia in a total of 10 of 63 (16%) additional trials. Nine patients were placed on chronic oral therapy with sotalol. In these nine patients long-term prophylaxis against ventricular tachycardia was documented over a mean follow-up period of 9.6 months (range 2-18 months). The study suggests that sotalol can provide effective prophylaxis against ventricular tachycardia in a significant proportion of patients refractory to other available drugs and that this prophylactic efficacy is predominantly due to its Class III anti-arrhythmic properties. Experimental studies were performed in eight conscious dogs 3-7 days following proximal LAD ligation. Epicardial recordings were obtained using implanted composite electrodes. Sotalol prevented sustained VT by a predominant increase in refractoriness of the infarcted zone. In vitro, sotalol caused a significant prolongation of the action potential of epicardial and endocardial fibres within both the infarcted and noninfarcted myocardium. Refractoriness of epicardial ventricular fibres was significantly more prolonged in ischemically damaged cells as compared to normal fibres.
18例持续性室性心动过速患者接受了系列电生理研究，以确定索他洛尔与其他可用抗心律失常药物相比的治疗效果。18例患者中有14例（78%）发现一种或多种急性有效药物。所有18例患者均接受了索他洛尔测试，其中12例（67%）有效。为评估其他抗心律失常药物的预防效果，每位患者平均额外进行了3.5次研究，在总共63次额外试验中有10次（16%）成功预防了室性心动过速。9例患者接受了索他洛尔慢性口服治疗。在这9例患者中，平均随访9.6个月（范围2 - 18个月）记录到对室性心动过速的长期预防。该研究表明，索他洛尔可在很大一部分对其他可用药物耐药的患者中有效预防室性心动过速，且这种预防效果主要归因于其Ⅲ类抗心律失常特性。在结扎左前降支近端3 - 7天后，对8只清醒犬进行了实验研究。使用植入式复合电极获取心外膜记录。索他洛尔通过显著增加梗死区的不应期来预防持续性室速。在体外，索他洛尔使梗死心肌和非梗死心肌的心外膜和心内膜纤维的动作电位显著延长。与正常纤维相比，缺血损伤细胞的心外膜心室纤维不应期显著延长。
