Efficacy of oral sotalol in suppression of premature ventricular complexes and analysis of its beta-adrenergic blocking activity

Abstract

The efficacy of oral DL-sotalol in suppressing premature ventricular complexes was assessed by Holter recordings in 28 patients during short term (two weeks) and long term (two years) trials, and its beta-adrenergic blocking effects were evaluated by heart rate response to the Bruce treadmill stress test and plasma catecholamine increases upon active standing. Sotalol produced a significant decrease (more than 85%) in the number of premature ventricular complexes, during both short term (54%) of patients) and long term (39% of patients) trials. The doses employed in this study (320 mg/day) produced mild to moderate degrees of beta-adrenergic blockade as suggested by: a 20% reduction in the mean heart rate on 48 h Holter monitoring (P less than 0.0005); a 15 to 30% reduction in tachycardia induced by strenuous exercise; and a 12% reduction in standing-induced tachycardia. Under long term sotalol therapy the increase in plasma noradrenaline concentrations in response to active standing was not modified, but the increase in plasma adrenaline concentrations was greater than under baseline conditions (P less than 0.025). Both systolic and diastolic blood pressures significantly increased during long term sotalol administration (P less than 0.005 and P less than 0.025, respectively). However, blood pressure remained within the normotensive range during sotalol therapy. It was concluded that sotalol provides, at effective antiarrhythmic doses, a satisfactory level of beta-adrenergic blockade which during standing was associated with significant changes in adrenaline plasma increments.(ABSTRACT TRUNCATED AT 250 WORDS)