This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Nademanee, K. Articles by Feld, G. K. Search for Related Content PubMed Articles by Nademanee, K. Articles by Feld, G. K. Social Bookmarking                         What's this?

Effects of Sotalol on His-Purkinje Conduction and Refractoriness in Humans

Department of Cardiology, West Los Angeles VA Medical Center, Los Angeles, California, Division of Cardiology. University of Southern California School of Medicine, Los Angeles, California

H. Elizabeth Noll

Sharp Rees-Stealy Medical Group. San Diego, California

Gregory K. Feld

University of California, San Diego

Background: The effects of sotalol on refractoriness in human ventricular and atrial muscles have been well established, but the drug's effect on the electrical properties of the His- Purkinje system in humans is not known, especially whether sotalol's effect is due solely to its action on prolonging repolarization or in combination with its beta-blocking properties. We studied the electrophysiologic effects of intravenous sotalol and propranolol in patients undergoing electrophysiologic studies of cardiac arrhythmias.

Methods and Results: We studied 22 patients (19 men, 3 women; mean age, 60 ± 6 years) who had coronary artery disease and assessable anterograde, retrograde, or both, His-Purkinje system function. Fifteen patients underwent electrophysiologic studies before and after intra venous sotalol (1.5 mg/kg), and 7 patients underwent electrophysiologic studies before and after intravenous propranolol (0.15 mg/kg). Both sotalol and propranolol had no signilicant effect on the H-V interval, but sotalol significantly increased ventricular refractoriness and His-Purkinje refractoriness, both in anterograde and retrograde conduction, whereas propra nolol did not. Sotalol's effect on His-Purkinje refractoriness also caused alrioventricular block distal to the His bundle during atrial pacing at a moderately fast rate. Sotalol was not effec tive in preventing bundle branch re-entry tachycardia, nevertheless. it increased cycle length of bundle branch re-entry tachycardia by increasing refractoriness.

Conclusions: Sotalol increased His-Purkinje refractoriness in humans but had no effect on His-Purkinje conduction. The drug must be used judiciously in patients with a diseased His- Purkinje system because it may cause atrioventricular block distal to His at fast heart rates. Sotalol had no effect on macrore-entry utilising bundle branches.

Key Words: sotalol • propranolol • cardiac arrhythmia. bundle branch re-entry tachycardia class II actions.

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 1, No. 1, 9-16 (1996)
DOI: 10.1177/107424849600100103


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				B. N. Singh Antiarrhythmic Therapy of Ventricular Arrhythmias: The Contemporary Dilemma Journal of Cardiovascular Pharmacology and Therapeutics, January 1, 1996; 1(1): 3 - 7. [PDF]