Evaluation The Efficacy Of Lower Dose Sotalol In Patients With Arrhythmias

Object To evaluate the safety and efficacy of oral sotalol versus propafenone of treatment for patients(pts) with premature ventricular beats, premature supraventricular beats and symptomatic paroxysmal atrial fibrillation.Material This study collected 90 pts ( 53 male, famale 37 ), age 16-80 years(57±15.17). Forty pts were with premature ventricular beats, 38 pts with premature supraventricular beats and 12 pts with symptomatic paroxysmal atrial fibrillation. The basic diseases: 32 with hypertension, 28 with coronary artery disease , 15 with rheumatic, 15 with unclear cause. Method All pts were divided into three subgroup: ventricular arrhythmias group(V), supraventricular arrhythmias group(SV) and symptomatic paroxysmal atrial fibrillation group(PAF). Each subgroup was randomize divided into sotalol and propafenone subgroups. In group sotalol (n=42) sotalol was given at an initial dose of 20mg/12hours ,after two days the dose was increased to 40 mg/12hours,and anther two days later, the dose was increased to 60 mg/12hours; in group of propafenone(n=38) , propafenone was given at a dose of 150 mg/8hours. After two weeks therapy, all pts were evaluated by 24-hour ambulatory Holter. The efficacy and tolerance for the medicine was assessed .Results: ① Ventricular arrhythmias group(V): for the total 40 pts, 22 pts oral sotalol: 3 of 22 pts were significant effective, 14 of 22 effective, 5 of 22 ineffective, the total effective rate was 77.2%; for 18 pts with oral propafenone: 13 of 18 effective, 4 of 18 ineffective, the total effective rate was 72.2%(P>0.05). ② Supraventricular arrhythmias group(SV): for the total 38 pts, 20 pts with oral sotalol: 4 of 20 pts were significant effective, 10 of 20 effective, 6 of 20 ineffective. The total effective rate was 70.0%. 18 pts with oral propafenone: 1 of 18 pts was significant effective, 11 of 18 effective, 5 of 18 ineffective. The total effective rate was 66.7%(P>0.05). ③ Paroxysmal atrial fibrillation group(PAF): for the total 12 pts, 12 pts with oral sotalol, 7 of 12 were effective. 5 of 12 were ineffective. The total effective rate was 58.3%. ④Analysis demonstrated: the effective rate of sotalol preventing premature ventricular beats was 77.2%, premature supraventricular beats was 70.0% respectively (P>0.05). ⑤ In the 40 pts treated with sotalol, the 24-hour average heat rate was decreased from 74.3±9.6 beats/minute at baseline to 65.4±7.5 beats/minute after treatment(P<0.01); Q-T interval was prolonged from 0.38±0.02s at baseline to 0.40±0.02s after treatment(P<0.01)⑥ All enrolled pts had completed the trial. In sotalol group there were 2 of 40 pts had gastrointestinal discomfort; In propafenone group there were 2 of 38 pts had gastrointestinal discomfort.Conclusions As a new antiarrhythmic drug, sotalol has its unique working mechanism,oral sotalol and propafenone are equally effective and safe to treat premature ventricular beats, premature supraventricular beats, and symptomatic paroxysmal atrial fibrillation. When sotalol was used in 120mg/d, there was a little side effect. Sotalol is a effective and safe antiarrhythmic drug.