Sotalol

Sotalol (trade name Betapace®, Berlex Laboratories) is a drug used in individuals with rhythm disturbances (cardiac arrhythmias) of the heart, and to treat hypertension in some individuals.

Pharmacology

It falls into the class of beta blockers (and class II antiarrhythmic agents) because of its primary action on the β-adrenergic receptors in the heart.

In addition to its actions on the beta receptors in the heart, sotalol inhibits the inward potassium ion channels of the heart. In so doing, sotalol prolongs repolarization, therefore lengthening the QT interval and decreasing automaticity. It also slows atrioventricular (AV) nodal conduction. Because of these actions on the cardiac action potential, it is also considered a class III antiarrhythmic agent.

Indications

Sotalol is used to treat ventricular tachycardias as well as atrial fibrillation.

Some evidence suggests that sotalol should be avoided in the setting of decreased ejection fraction due to heart attack.

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