Sotalol

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

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Pharmacology

It falls into the class III antiarrhythmic agents because it inhibits the inward potassium ion channels in the heart. It is also a beta blocker because of its primary action on the β-adrenergic receptors in the heart.

By blocking the potassium channels, sotalol prolongs repolarization, therefore lengthening the QT interval and decreasing automaticity.

It also slows atrioventricular (AV) nodal conduction (beta-blocking effect).

Sotalol is a racemic mix of D and L enantiomers. The L isomer is a beta blocker.

Sotalol is not selected for its beta-blocking ability, but rather for its Class III (potassium blocking) properties.

Indications

Sotalol is used to treat ventricular tachycardias as well as atrial fibrillation. Betapace AF is specifically labeled for atrial fibrillation.

Some evidence suggests that sotalol should be avoided in the setting of decreased ejection fraction due to heart attack.^[1]

See also

• Antiarrhythmic agents
• Beta blocker