Young G D, Kerr C R, Mohama R, Boone J, Yeung-Lai-Wah J A
Department of Medicine, University of British Columbia, Vancouver, Canada.
Am J Cardiol. 1994 Apr 1;73(9):677-82. doi: 10.1016/0002-9149(94)90933-4.
Sotalol is a class III antiarrhythmic drug with additional beta-blocker activity that has been shown to be effective in supraventricular and ventricular arrhythmias. Its long-term efficacy for ventricular arrhythmias is not as well described. Patients with documented sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) who had their clinical arrhythmia inducible at baseline electrophysiologic study received sotalol 320 to 640 mg/day. Repeat programmed stimulation was performed after a minimum of 72 hours while receiving the final dose. Of 28 patients (25 men and 3 women) whose arrhythmias were inducible at baseline, 15 had their arrhythmias suppressed with sotalol. Sotalol had greater success in suppressing arrhythmias in those with VF (8 of 9, 89%) than in those with VT (7 of 19, 37%, p < 0.01). In patients with a history of coronary artery disease but no history of myocardial infarction the arrhythmia was suppressed in 7 of 8 (88%) compared with 8 of 20 (40%, p < 0.05) patients with a history of myocardial infarction. All 15 patients in whom ventricular arrhythmias were suppressed continued to take long-term sotalol, and at a follow-up of 10.3 +/- 6.4 months none has had arrhythmia recurrence. Thus, sotalol is an effective drug for the suppression of ventricular arrhythmias as judged by programmed electrical stimulation. It appears to be more effective in patients in whom the clinical arrhythmia is VF rather than VT.
索他洛尔是一种Ⅲ类抗心律失常药物，具有额外的β受体阻滞剂活性，已被证明对室上性和室性心律失常有效。其对室性心律失常的长期疗效描述较少。在基线电生理研究中可诱发临床心律失常的记录有持续性室性心动过速（VT）或室颤（VF）的患者，接受320至640毫克/天的索他洛尔治疗。在接受最后一剂药物后至少72小时进行重复程序刺激。在28例（25例男性和3例女性）基线时可诱发心律失常的患者中，15例患者的心律失常被索他洛尔抑制。索他洛尔在抑制VF患者的心律失常方面（9例中的8例，89%）比VT患者（19例中的7例，37%，p<0.01）更成功。在有冠心病病史但无心肌梗死病史的患者中，8例中有7例（88%）心律失常被抑制，而有心肌梗死病史的20例患者中有8例（40%，p<0.05）心律失常被抑制。所有15例室性心律失常被抑制的患者继续长期服用索他洛尔，在10.3±6.4个月的随访中，无一例心律失常复发。因此，根据程序电刺激判断，索他洛尔是一种抑制室性心律失常的有效药物。它在临床心律失常为VF而非VT的患者中似乎更有效。
