Sotalol (Betapace®, Berlex Laboratories) is a drug used in individuals with rhythm disturbances (cardiac arrhythmias) of the heart. 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.

Sotalol is used to treat ventricular tachycardias as well as atrial fibrillation. It may be taken orally, since its bioavailability is almost 100%.

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

References

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1. Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF, Pitt B, Pratt CM, Schwartz PJ, Veltri EP. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. Lancet. 1996 Jul 6;348(9019):7-12. (Medline abstract)

See also

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• Antiarrhythmic agents
• Beta blocker

Antiarrhythmic agents | Beta blockers

Sotalol