Author + information
- Arun Kanmanthareddy,
- Madhu Reddy,
- Venkata Alla,
- Dixitha Anugula,
- Vivek Yarlagadda,
- Pradyumna Agasthi,
- Madhav Lavu,
- Sudharani Bommana,
- Donita Atkins,
- Claire Hunter,
- Aryan Mooss,
- Andrea Natale and
- Dhanunjaya Lakkireddy
Background: Sotalol is a class III anti-arrhythmic drug. According to the 2014 AHA/ACC/HRS guidelines on atrial fibrillation (AF), sotalol has a class I recommendation for use in maintenance of sinus rhythm but there are no recommendations regarding its use for pharmacologic cardioversion in AF.
Methods: We searched PubMed, Google Scholar, EBSCO databases for randomized controlled studies comparing sotalol versus other antiarrhythmic medications for the treatment of AF. Data on efficacy of cardioversion of AF and maintenance of sinus rhythm was synthesized using STATA 13 software and risk ratio (RR) with 95% CI were calculated.
Results: A total of 24 randomized controlled studies (5,823 patients) were included. Cardioversion efficacy of sotalol was similar to class I agents (RR 0.88, 95% CI 0.62 – 1.26), amiodarone (RR 0.94, 95% CI 0.80 – 1.12) and quinidine (RR 0.78, 95% CI 0.52 – 1.19). Only high dose Ibutilide has a better efficacy than sotalol (RR 0.43, 95% CI 0.25 – 0.74). Maintenance of sinus rhythm was significantly lower when compared to amiodarone (RR 0.70, 95% CI 0.60 – 0.81) but was similar to class I agents other than quinidine (RR 1, 95% CI 0.79 – 1.28), dofetilide (RR 0.85, 95% CI 0.61 – 1.19) and quinidine (RR 0.96, 95% CI 0.85 – 1.09).
Conclusions: Sotalol appears to have similar efficacy to class I anti-arrhythmic agents for cardioversion and maintenance of sinus rhythm. Its efficacy is similar to that of amiodarone in cardioversion but has lower efficacy in maintaining sinus rhythm compared to amiodarone.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Atrial Fibrillation and VT: Unique Populations and Solutions
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1151-103
- 2017 American College of Cardiology Foundation