sotalol / Generic mfg. - LARVOL DELTA

Risk of serious bleeding with concomitant use of apixaban or rivaroxaban with amiodarone compared to flecainide or sotalol in patients with atrial fibrillation (ASH 2025) - "Covariates were well balanced post-matching (standardized differences <0.1).After matching, 253 patients in the amiodarone group experienced serious bleeding (25.8 events per1,000 person-years) compared to 175 in the comparator group (16.4 events per 1,000 person-years) (HR,1.53; 95% CI, 1.26 to 1.86).CONCLUSIONIn this comparative safety study, among patients with AF treated with apixaban or rivaroxaban,concomitant use of amiodarone was associated with a higher risk of serious bleeding compared to use offlecainide or sotalol. These findings highlight the importance of considering drug-drug interactions whenmanaging anticoagulated patients with AF to promote safe prescribing and minimize the risk of seriousbleeding complications."

Clinical • Asthma • Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • Hepatology • Immunology • Nephrology • CYP3A4 • PER1

Catheter Ablation vs. Anti-Arrhythmic Drug Therapy for Ventricular Tachycardia in Ischemic Heart Disease: A Meta-Analysis of Randomized Controlled Trials. (PubMed, Europace) - "In ischemic heart disease and VT, catheter ablation compared with anti-arrhythmic drugs is associated with a reduction of appropriate ICD therapy, cardiovascular rehospitalization and adverse events with benefits most evident versus sotalol."

Journal • Retrospective data • Cardiomyopathy • Cardiovascular • Coronary Artery Disease • Heart Failure • Ventricular Tachycardia

Catheter Ablation Versus Antiarrhythmic Drug Therapy for Ventricular Tachycardia in Structural Heart Disease: A Meta-Analysis of Randomized Controlled Trials (AHA 2025) - "Antiarrhythmic drugs used were amiodarone, sotalol, mexiletine, and procainamide, with earlier studies using a wide array of therapies and later often using only amiodarone and sotalol. Catheter ablation significantly reduces the risk of VT recurrence, VT storm, and hospitalizations compared to AAD therapy in patients with structural heart disease. Although no mortality benefit was observed, these findings support catheter ablation as a potentially superior initial strategy for VT management in this population. More high-quality studies are warranted to clarify the long-term safety and effectiveness of this procedure."

Retrospective data • Cardiovascular • Heart Failure • Ventricular Tachycardia

A Rare Presentation of Pancytopenia - Amiodarone-Induced Bone Marrow Granuloma (ASH 2023) - "Management: Amiodarone was discontinued and was switched to sotalol by cardiology. However, considering the wide array of potential causes of bone marrow granuloma, including infectious diseases, malignancy, or inflammatory diseases, physicians must thoroughly investigate and exclude other plausible causes before making the diagnosis. Nevertheless, it is crucial for physicians to include amiodarone as the differential diagnosis of pancytopenia as it can be easily reversed by the discontinuation of amiodarone."

Cardiovascular • Endocrine Disorders • Gastric Cancer • Gastrointestinal Cancer • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Oncology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Sarcoidosis • Tuberculosis

Catheter Ablation vs Sotalol or Amiodarone for Ventricular Tachycardia: A Substudy of the VANISH2 Trial. (PubMed, J Am Coll Cardiol) - P4 | "In the sotalol-eligible patients, ablation led to lower risk of the primary composite endpoint. In the amiodarone-eligible group, efficacy outcomes were comparable between ablation and amiodarone. Adverse events were more marked among patients randomized to amiodarone (Antiarrhythmics or Ablation for Ventricular Tachycardia 2 [VANISH2]; NCT02830360)."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Immunology • Infectious Disease • Myocardial Infarction • Pneumonia • Pulmonary Disease • Respiratory Diseases • Septic Shock • Ventricular Tachycardia

Data Analysis for Drug Repurposing for Effective Alzheimer's Medicines (DREAM)- Propranolol/Carvedilol Versus Atenolol/Bisoprolol/Sotalol (clinicaltrials.gov) - P=N/A | N=817337 | Completed | Sponsor: Brigham and Women's Hospital | Active, not recruiting ➔ Completed

Trial completion • Alzheimer's Disease • Cardiovascular • CNS Disorders • Hypertension

Characteristics and Outcomes of Mavacamten Use in 2440 Patients With Obstructive Hypertrophic Cardiomyopathy. (PubMed, J Am Heart Assoc) - "Over an 8-month median follow-up on mavacamten in patients with obstructive hypertrophic cardiomyopathy, new AF/AFL and HF occurred in 5% and 4%, respectively. Further work is needed to better understand the expected incidence of AF/AFL, HF, and other long-term outcomes of mavacamten treatment in obstructive hypertrophic cardiomyopathy."

Journal • Atrial Fibrillation • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Genetic Disorders • Heart Failure • Hypertrophic Cardiomyopathy • Obesity • Obstructive Hypertrophic Cardiomyopathy • Ventricular Tachycardia

Flecainide Reduces Exercise-Induced Arrhythmic Burden in PKP2-Related Arrhythmogenic Cardiomyopathy (AHA 2025) - "Eight patients (mean age 31 ± 13 years, 50% male) underwent both on and off flecainide for a total of 29 ESTs [on beta-blockers (80%), flecainide (52%), amiodarone (3%), or sotalol (3%)]. Flecainide significantly reduces the EST arrhythmic burden in patients with PKP2-ACM, particularly in the recovery phase. Future studies are needed to determine if the EST can be used to guide flecainide dosing and efficacy in PKP2-ACM akin to current strategies employed for catecholaminergic polymorphic ventricular tachycardia."

Cardiomyopathy • Cardiovascular • Ventricular Tachycardia

Intravenous sotalol in pediatric cardiac intensive care patients compared to other antiarrhythmics: insights from a multicenter database (AHA 2025) - "Intravenous sotalol use in pediatric intensive care patients was associated with lower inpatient mortality and comparable length of stay compared to amiodarone and procainamide after regression analyses. These results support that intravenous sotalol is a safe alternative for pediatric arrhythmia management, meriting further prospective studies."

Clinical • Cardiovascular • Critical care • Heart Failure • Pediatrics • Ventricular Tachycardia

Temporary Atrial Pacing to Lower Left Ventricular Filling Pressures in Restrictive Cardiomyopathy: A Case Report (AHA 2025) - "His home sotalol was changed to amiodarone to improve rhythm control, but this resulted in bradycardia, further contributing to symptoms.Hypothesis:Given his restrictive cardiomyopathy, we suspected a fixed stroke volume and heart rate dependency for cardiac output (CO). Current treatment of advanced diastolic heart failure (Figure 3) focuses primarily on preload reduction. We propose atrial pacing to shorten diastolic filling time as an alternate approach to lower left ventricular filling pressures. Further studies are warranted to explore device-based therapy for these patients."

Case report • Clinical • Amyloidosis • Atrial Fibrillation • Cardiac Amyloidosis • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Endocrine Disorders • Heart Failure • Hypertension • Metabolic Disorders • Nephrology • Type 2 Diabetes Mellitus

Longitudinal Evaluation of Anti-Arrhythmic Drug Use to Predict Hospitalization or Death in Patients with Ventricular Tachycardia (AHA 2025) - "From then, use of AADs (beta-blockers, sotalol, amiodarone, dofetilide, mexiletine) in the three years following were assessed on a quarterly basis. Linking AAD use with clinical outcomes is an important first step in identifying which patient profiles respond to which individual AADs and developing tailored VT treatment approaches. Here, we demonstrate profiles of VT patients at higher risk for hospitalization or death based on individual AADs."

Clinical • Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Ventricular Tachycardia

Impact of Antiarrhythmic Use on Primary Graft Dysfunction in Orthotopic Heart Transplant Patients: A Single Center Retrospective Cohort Study (AHA 2025) - "Anti-arrhythmic medications such as amiodarone have been noted to increase the risk of PGD and thus normally discontinued when patients reach a UNOS level 1-3 status...Out of the patients who had OHT and antiarrhythmics up till the day of transplant; 11 were on mexiletine; 9 were on sotalol; 7 were on digoxin; 2 were on dofetilide; and 1 on quinidine, lidocaine, and disopyramide respectively... Patients on sotalol had 5.49 times more odds off having PGD post-transplant and this was statistically significant regardless of age, gender and race."

Retrospective data • Cardiovascular • Congestive Heart Failure • Heart Failure • Transplantation

Multi-Modality Imaging in Giant Cell Myocarditis (AHA 2025) - "Pathology from an endomyocardial biopsy showed dense lymphocytic and eosinophilic infiltrate with multinucleated giant cells without granulomas, consistent with GCM.Sotalol was initiated to suppress ventricular ectopy while pathology was pending but was ineffective. The patient was switched to amiodarone. After diagnosis of GCM, the patient received prednisone and cyclosporine...Repeat PET demonstrated complete resolution of FDG-avidity.GCM requires prompt diagnosis and treatment to prevent mortality and morbidity. While endomyocardial biopsy remains the gold standard for diagnosis, non-invasive imaging allows for earlier diagnosis and assessment of response."

Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Inflammation • Ventricular Tachycardia

Tachycardia-induced Cardiomyopathy from Incessant Atrial Tachycardia in a Teenager with Severe Pectus Excavatum (AHA 2025) - "Initial medical therapy with ivabradine, flecainide, and atenolol led to rate control and subsequent improvement in left ventricular function but failed to terminate the arrhythmia...Postoperatively, left ventricular function normalized, but AT persisted despite continued escalation to ivabradine, sotalol, and flecainide...The p wave morphology on electrocardiogram, left atrial deformity on echocardiogram, and intracardiac activation map of the AT focus in this case, support cardiac compression as the mechanism for AT. These findings suggest the potential for sustained atrial remodeling with subsequent arrhythmia in the context of PE and underscores the importance of cardiac screening in asymptomatic adolescents with severe chest wall deformities."

Cardiomyopathy • Cardiovascular • Pediatrics

Deep Learning–Based Continuous QT Monitoring Identifies High-Risk Prolongation Events After Class III Antiarrhythmic Initiation (AHA 2025) - "A). We retrospectively analyzed 72,919 outpatient ECGs from 1,676 patients who were on dofetilide or sotalol across 2,083 unique outpatient encounters (Stanford, 2008–2024). One in six patients had documented QTc prolongation after discharge and had a fourfold increase of critical ventricular arrhythmia risk. 3DRECON-QT accurately identified these events from single-lead derived ICM signals, supporting its potential to close the outpatient surveillance gap in QT interval/risk monitoring."

Cardiovascular

Concomitant use of direct oral anticoagulants and interacting antiarrhythmic drugs and the risk of stroke and bleeding among patients with non-valvular atrial fibrillation: a multinational cohort study. (PubMed, BMC Med) - "Concomitant use of interacting antiarrhythmic drugs does not seem to affect the effectiveness of DOACs but may increase their risk of major bleeding."

Journal • Atrial Fibrillation • Cardiovascular • Ischemic stroke

FROM ANTIARRHYTHMIC TO ARRHYTHMOGENIC: A CASE OF SOTALOL TOXICITY (CHEST 2025) - "Sotalol possesses unique pharmacologic properties which make it lethal in overdose and create nuance in management of such overdoses as compared to other beta antagonists. Due to sotalol's prolongation of the QTc, interventions which may exacerbate this should be cautiously implemented. Catecholaminergic agents should be chosen based on their ability to provide overdrive pacing and if unsuccessful, transvenous pacing is an appropriate alternative."

Clinical • Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension • Nephrology

PACEMAKER RESCUE AND HEMODIALYSIS: A LIFELINE IN SOTALOL OVERDOSE (CHEST 2025) - "This case highlights the importance of recognizing sotalol toxicity and implementing timely interventions, including hemodialysis, to facilitate drug clearance.The use of pacemaker rate adjustment as a supportive measure underscores the role of individualized management strategies in cases of drug-induced cardiogenic shock."

Atrial Fibrillation • Cardiovascular • Hypotension • Ventricular Tachycardia

AMIODARONE-INDUCED ACUTE RESPIRATORY DISTRESS SYNDROME: A SERIOUS PULMONARY COMPLICATION (CHEST 2025) - "He was receiving Amiodarone, Metoprolol, and Sotalol for arrhythmia prevention...Management included discontinuation of amiodarone, initiation of Cefepime, Doxycycline, Bactrim, and Methylprednisolone (40 mg three times daily)...The patient was discharged on prednisone (40 mg daily for two weeks)... Amiodarone lung toxicity can present as acute respiratory distress syndrome (ARDS). Patients on Amiodarone should be monitored for possible lung toxicity either by imaging or close pulmonary follow ups. Steroids administration is effective in managing amiodarone lung toxicity with favorable outcomes."

Acute Respiratory Distress Syndrome • Cardiovascular • Coronary Artery Disease • Cough • Diabetes • Heart Failure • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Inflammation • Metabolic Disorders • Pneumonia • Respiratory Diseases • Ventricular Tachycardia

Tribute to Alberto J. Kaumann. (PubMed, Naunyn Schmiedebergs Arch Pharmacol) - "Last not least, he explained the antiarrhythmic effect of sotalol by prolongation of the cardiac action potential duration, providing for the first time, what was years later to be defined as class III antiarrhythmic action. With Alberto Kaumann, we have lost a colleague and friend who had dedicated his life to science and music."

Journal • Review • Cardiovascular

BETA-BLOCKERS ARE ASSOCIATED WITH LOWER RISK OF PANCREATIC CANCER IN PATIENTS WITH TYPE 2 DIABETES: A POPULATION-BASED COHORT STUDY (UEGW 2025) - "Primary exposure was beta-blocker use (e.g., acebutotlol, atenolol, bisoprolol, carvedilol, celiprolol, esmolol, labetalol, metoprolol, nadolol, nebivolol, pindolol, propranolol, and sotalol)...Adjusted hazard ratios (aHRs) were derived from multivariable Cox models adjusting for 31 covariates: age, sex, smoking status, alcohol use disorder, body index mass, glycemic control (in terms of time-weighted mean HbA1c), pancreatitis, cholangitis, colectomy, Charlson's comorbidity index, metabolic and cardiovascular comorbidities, and concomitant medications (aspirin, non-steroidal anti-inflammatory drugs, statins, and other antidiabetics)... Beta-blocker use was associated with a lowered risk of PC among patients with newly diagnosed T2D, in a dose- and duration-dependent manner."

Clinical • Addiction (Opioid and Alcohol) • Diabetes • Gastrointestinal Disorder • Hepatology • Metabolic Disorders • Oncology • Pancreatic Cancer • Pancreatitis • Solid Tumor • Type 1 Diabetes Mellitus • Type 2 Diabetes Mellitus

Ventricular Tachycardia Cycle Length and Response to Rhythm Control Therapy: Insights From the VANISH Trial. (PubMed, JACC Clin Electrophysiol) - No abstract available

Journal • Cardiovascular • Myocardial Infarction • Ventricular Tachycardia

Nifekalant for Atrial Tachycardia-Induced Cardiogenic Shock in a Patient With Severe Left Ventricular Systolic Dysfunction. (PubMed, JACC Case Rep) - "Nifekalant may be effective for refractory AT in patients with severely reduced LVEF and hemodynamic instability."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure

I'm in two hearts about this diagnosis! (EUSEM 2025) - "Previous medical history included heterotropic heart transplant for myocarditis and long term oral amiodarone therapy. Patient was later discharged clinically and hemodynamically stable with oral sotalol and mexilitine. This rare and complex case highlights the importance of ECG interpretation in diagnosing arrhythmias in post-transplant patients."

Cardiovascular • Inflammation • Ventricular Tachycardia

Cardiogenic shock treated with mechanical circulatory support due to flecainide poisoning (EUSEM 2025) - "His medical history included atrial fibrillation, managed with Sotalol and Rivaroxaban. What initially appeared to be a case of hemorrhagic stroke was ultimately identified as a drug poisoning. Timely differential diagnosis, effective hemodynamic support, and identification of the substances involved were crucial in saving the patient's life."

Atrial Fibrillation • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders