Skip to main content
PMC home page
British Heart Journal logoLink to British Heart Journal
. 1982 Jun;47(6):515–520. doi: 10.1136/hrt.47.6.515

Electrophysiological effects of sotalol--just another beta blocker?

A W Nathan, K J Hellestrand, R S Bexton, D E Ward, R A Spurrell, A J Camm
PMCID: PMC481176  PMID: 7082499

Abstract

The electrophysiological effects of intravenous sotalol hydrochloride (0.4 mg/kg) were assessed in 24 patients, including 13 with the Wolff-Parkinson-White syndrome, undergoing routine electrophysiological study. Fifteen to 30 minutes after sotalol administration there was a significant increase in sinus cycle length and in sinus node recovery time. There was a small increase in the AH interval, but the HV interval was unchanged. The QT and JT intervals, measured during sinus rhythm, were both increased. The atrial, ventricular, and atrioventricular nodal effective refractory periods were all prolonged, as was the atrioventricular nodal functional refractory period. In 13 patients with ventricular pre-excitation there was an increase of the accessory pathway anterograde and retrograde effective refractory periods. In 12 of these 13 sotalol was given during atrioventricular re-entrant tachycardia, resulting in termination in five. Tachycardia cycle length increased in all patients, with the major effect being in the atrioventricular direction. Though some of the effects seen in these patients are consistent with the beta adrenergic antagonist properties of sotalol, the effect on atrial, ventricular, and accessory pathway effective refractory periods and on ventricular repolarisation is not typical of that observed with other beta blockers but may be the result of lengthening of the action potential duration. These findings suggest that sotalol may be a more versatile antiarrhythmic agent than other beta receptor antagonists.

Full text

PDF
519

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akhtar M., Damato A. N., Batsford W. P., Ruskin J. N., Ogunkelu J. B. A comparative analysis of antegrade and retrograde conduction patterns in man. Circulation. 1975 Nov;52(5):766–778. doi: 10.1161/01.cir.52.5.766. [DOI] [PubMed] [Google Scholar]
  2. Bekheit S., Murtagh J. G., Morton P., Fletcher E. Measurements of sinus impulse conduction from electrogram of bundle of His. Br Heart J. 1971 Sep;33(5):719–724. doi: 10.1136/hrt.33.5.719. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Denes P., Cummings J. M., Simpson R., Wu D., Amat-Y-Leon F., Dhingra R., Rosen K. M. Effects of propranolol on anomalous pathway refractoriness and circus movement tachycardias in patients with preexcitation. Am J Cardiol. 1978 May 22;41(6):1061–1067. doi: 10.1016/0002-9149(78)90858-5. [DOI] [PubMed] [Google Scholar]
  4. Denes P., Wu D., Dhingra R., Pietras R. J., Rosen K. M. The effects of cycle length on cardiac refractory periods in man. Circulation. 1974 Jan;49(1):32–41. doi: 10.1161/01.cir.49.1.32. [DOI] [PubMed] [Google Scholar]
  5. Di Biase M., Brindicci G., Rizzon P. Effects of prindolol on impulse formation and conduction in man. J Electrocardiol. 1977 Jan;10(1):45–50. doi: 10.1016/s0022-0736(77)80030-7. [DOI] [PubMed] [Google Scholar]
  6. Di Biase M., Guglielmi R., Scarcia A., Chiddo A., Rizzon P. Electrophysiologic properties of intravenous oxprenolol in man. J Electrocardiol. 1977 Jul;10(3):267–273. doi: 10.1016/s0022-0736(77)80069-1. [DOI] [PubMed] [Google Scholar]
  7. Edvardsson N., Hirsch I., Emanuelsson H., Pontén J., Olsson S. B. Sotalol-induced delayed ventricular repolarization in man. Eur Heart J. 1980 Oct;1(5):335–343. doi: 10.1093/eurheartj/1.5.335. [DOI] [PubMed] [Google Scholar]
  8. Elonen E., Neuvonen P. J., Tarssanen L., Kala R. Sotalol intoxication with prolonged Q-T interval and severe tachyarrhythmias. Br Med J. 1979 May 5;1(6172):1184–1184. doi: 10.1136/bmj.1.6172.1184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Facquet J., Nivet M., Grosgogeat Y., Alhomme P., Vachon J. L'influence de l'aminodarone sur le rythme cardiaque et l'électrocardiogramme. Therapie. 1970 Mar-Apr;25(2):335–341. [PubMed] [Google Scholar]
  10. Fitzgerald J. D. Perspectives in adrenergic beta-receptor blockade. Clin Pharmacol Ther. 1969 May-Jun;10(3):292–306. doi: 10.1002/cpt1969103292. [DOI] [PubMed] [Google Scholar]
  11. Frankl W. S., Soloff L. A. Sotalol: a new, safe beta adrenergic receptor blocking agent. Am J Cardiol. 1968 Aug;22(2):266–272. doi: 10.1016/0002-9149(68)90233-6. [DOI] [PubMed] [Google Scholar]
  12. Kontopoulos A., Filindris A., Manoudis F., Metaxas P. Satalol-induced torsade de pointes. Postgrad Med J. 1981 May;57(667):321–323. doi: 10.1136/pgmj.57.667.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Latour Y., Dumont G., Brosseau A., LeLorier J. Effects of sotalol in twenty patients with cardiac arrhythmias. Int J Clin Pharmacol Biopharm. 1977 Jun;15(6):275–278. [PubMed] [Google Scholar]
  14. Mandel W., Hayakawa H., Danzig R., Marcus H. S. Evaluation of sino-atrial node function in man by overdrive suppression. Circulation. 1971 Jul;44(1):59–66. doi: 10.1161/01.cir.44.1.59. [DOI] [PubMed] [Google Scholar]
  15. McComb J. M., Logan K. R., Khan M. M., Geddes J. S., Adgey A. A. Amiodarone-induced ventricular fibrillation. Eur J Cardiol. 1980;11(5):381–385. [PubMed] [Google Scholar]
  16. Milne J. R., Camm A. J., Ward D. E., Spurrell R. A. Effect of intravenous propranolol on QT interval. A new method of assessment. Br Heart J. 1980 Jan;43(1):1–6. doi: 10.1136/hrt.43.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Myburgh D. P., Goldman a. P., Cartoon J., Schamroth J. M. The efficacy of sotalol in suppressing ventricular ectopic beats. S Afr Med J. 1979 Aug 25;56(8):295–298. [PubMed] [Google Scholar]
  18. Narula O. S., Cohen L. S., Samet P., Lister J. W., Scherlag B., Hildner F. J. Localization of A-V conduction defects in man by recording of the His bundle electrogram. Am J Cardiol. 1970 Feb;25(2):228–237. doi: 10.1016/0002-9149(70)90583-7. [DOI] [PubMed] [Google Scholar]
  19. Neuvonen P. J., Elonen E., Tanskanen A., Tuomilehto J. Sotalol and prolonged Q-Tc interval. Lancet. 1981 Aug 22;2(8243):426–426. doi: 10.1016/s0140-6736(81)90876-x. [DOI] [PubMed] [Google Scholar]
  20. Robinson C., Birkhead J., Crook B., Jennings K., Jewitt D. Clinical electrophysiological effects of atenolol--a new cardioselective beta-blocking agent. Br Heart J. 1978 Jan;40(1):14–21. doi: 10.1136/hrt.40.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Ruskin J. N., Caracta A. R., Akhtar M., Batsford W. P., Damato A. N. Electrophysiologic effects of tolamolol on atrioventricular conduction in man. Am Heart J. 1975 Dec;90(6):755–766. doi: 10.1016/0002-8703(75)90465-2. [DOI] [PubMed] [Google Scholar]
  22. Seides S. F., Josephson M. E., Batsford W. P., Weisfogel G. M., Lau S. H., Damato A. N. The electrophysiology of propranolol in man. Am Heart J. 1974 Dec;88(6):733–741. doi: 10.1016/0002-8703(74)90283-x. [DOI] [PubMed] [Google Scholar]
  23. Singh B. N., Vaughan Williams E. M. A third class of anti-arrhythmic action. Effects on atrial and ventricular intracellular potentials, and other pharmacological actions on cardiac muscle, of MJ 1999 and AH 3474. Br J Pharmacol. 1970 Aug;39(4):675–687. doi: 10.1111/j.1476-5381.1970.tb09893.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Strauss H. C., Bigger J. T., Jr, Hoffman B. F. Electrophysiologial and beta-receptor blocking effects of MJ 1999 on dog and rabbit cardiac tissue. Circ Res. 1970 Jun;26(6):661–678. doi: 10.1161/01.res.26.6.661. [DOI] [PubMed] [Google Scholar]
  25. Strauss H. C., Gilbert M., Svenson R. H., Miller H. C., Wallace A. G. Electrophysiologic effects of propranolol on sinus node function in patients with sinus node dysfunction. Circulation. 1976 Sep;54(3):452–459. doi: 10.1161/01.cir.54.3.452. [DOI] [PubMed] [Google Scholar]
  26. Tonkin A. M., Miller H. C., Svenson R. H., Wallace A. G., Gallagher J. J. Refractory periods of the accessory pathway in the Wolff-Parkinson-White syndrome. Circulation. 1975 Oct;52(4):563–569. doi: 10.1161/01.cir.52.4.563. [DOI] [PubMed] [Google Scholar]
  27. Ward D. E., Camm A. J., Spurrell R. A. The acute cardiac electrophysiological effects of intravenous sotalol hydrochloride. Clin Cardiol. 1979 Jun;2(3):185–191. doi: 10.1002/clc.4960020303. [DOI] [PubMed] [Google Scholar]
  28. Ward D. E., Camm A. J., Spurrell R. A. The response of regular re-entrant supraventricular tachycardia to right heart stimulation. Pacing Clin Electrophysiol. 1979 Nov;2(6):586–595. doi: 10.1111/j.1540-8159.1979.tb04277.x. [DOI] [PubMed] [Google Scholar]
  29. Wellens H. J., Lie K. I., Bär F. W., Wesdorp J. C., Dohmen H. J., Düren D. R., Durrer D. Effect of amiodarone in the Wolff-Parkinson-White syndrome. Am J Cardiol. 1976 Aug;38(2):189–194. doi: 10.1016/0002-9149(76)90148-x. [DOI] [PubMed] [Google Scholar]
  30. Wit A. L., Weiss M. B., Berkowitz W. D., Rosen K. M., Steiner C., Damato A. N. Patterns of atrioventricular conduction in the human heart. Circ Res. 1970 Sep;27(3):345–359. doi: 10.1161/01.res.27.3.345. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES