Reviews Therapeutic Use of Amiodaron and Sotalol in Ventricular Arrhythmias

Several approaches to the treatment of the ventricular tachyarrhythmias are currently present and include pharmacological as well as nonpharmacologic interventions, such as implantation of electrical devices or catheter ablation. Although nonpharmacological treatment methods are increasingly used, drug therapy still remains the most widely used treatment strategy for the management of ventricular arrhythmias. At present, class III antiarrhythmi c agents especially amiodarone and sotalol are favored increasingly to treat patients with ventricular arrhythmias. Amiodarone is usually classified as a class III antiarrhytmic agent, but it also has class I (blocks sodium channels), class II (antiadrenergic actions), and class IV effects (blocks calcium channels). It is highly effective against a wide range of arrhythmias. Controlled Irials are now under way that will provide further information about amiodarone in different groups of patients. Unfortunately, it is associated with frequent side effects; some of them necessitate drug discontinuation. Sotalol is a nonselective ß-adrenoceptor antagonist which also prolongs cardiac repolarisation. Sotalol may be effective in patients with cardiac disease by reducing myocardial ischemia, reducing the arryhythmogenic effect of carecholamines or by a direct antiarrhythmic action. Sotalol has been evaluated in several trials fort he suppresion of ventricular arrhythmic. It is effective in suppressing ventricular ectopy and life -threatening ventricular arrhythnmias that have been refractory to other conventional antiarrhythmic drugs. In general, sotalol is well tolerated. Many of its adverse effects are caused by beta blocking activity. The overall arrhythmogenic potential is moderately low, but torsade de pointes may develop in conjunction with excessive prolongation of the QT interval due to bradycardia. hypokalemia or high plasma concentrations of the drug.