Sotalol is conventionally initiated in the inpatient setting for monitoring efficacy and adverse effects, including QTc interval prolongation and torsades de pointes (TdP) proarrhythmia.

We aimed to evaluate the efficacy and safety of outpatient initiation of sotalol for the treatment of atrial fibrillation (AF) in a select group of patients with cardiac implantable electronic devices (CIEDs) capable of continuous rhythm monitoring remotely.

Over a long follow-up period, sotalol was continued at a steady dose in the majority of patients who were able to maintain sinus rhythm. No adverse effects relating to QTc prolongation and TdP or mortality were observed in these patients.

Effective and safe outpatient initiation and maintenance of sotalol therapy is possible in select patients who have CIEDs for continuous remote monitoring and surveillance capabilities.