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Electrophysiologic Study‐Guided Therapy with Sotalol for Life‐Threatening Ventricular Tachyarrhythmias
Author(s) -
WATANABE HIROSHI,
CHINUSHI MASAOMI,
WASHIZUKA TAKASHI,
SUGIURA HIROTAKA,
HIRONO TAKASHI,
KOMURA SATORU,
HOSAKA YUKIO,
TANABE YASUTAKA,
FURUSHIMA HIROSHI,
FUJITA SATOSHI,
KATO KIMINORI,
AIZAWA YOSHIFUSA
Publication year - 2005
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.2005.09413.x
Subject(s) - medicine , sotalol , cardiology , anti arrhythmia agents , anesthesia , atrial fibrillation
The aim of this study was to investigate the long‐term efficacy and safety of electrophysiologic study (EPS)‐guided sotalol administration combined with implantable cardioverter defibrillators (ICD) for ventricular tachyarrhythmias (VTA). This study enrolled 92 patients with both structural heart disease and sustained VTA. Sotalol was administered to 57 patients, and its efficacy was assessed by EPS. Long‐term treatment was continued in combination with ICD in 31 patients (57%) whose VTA was no longer inducible (responder group) and in 16 patients whose VTA remained inducible (nonresponder group). The long‐term outcomes were compared among the responder group, the nonresponder group, and 35 ICD recipients untreated with antiarrhythmic drugs (ICD‐only group). During a mean follow‐up of 44 ± 33 months, the recurrence of VTA was not significantly different between all patients treated with sotalol (30%) and patients in the ICD‐only group (46%). However, the recurrence of VTA was significantly lower in the responder (13%) than in the nonresponder (63%) or the ICD‐only groups (46%). There was no significant difference in VTA recurrence between the nonresponder and the ICD‐only groups. One patient each in the responder and the ICD‐only groups died suddenly, and all‐cause mortality was similar in the three groups. The incidence of inappropriate ICD discharges was less in the sotalol than in the ICD‐only groups. No patient had to discontinue long‐term sotalol treatment because of the adverse effects. In conclusion, sotalol reduced VTA recurrence in the responding patients and inappropriate ICD discharge. EPS may predict the efficacy of sotalol for VTA recurrence.