Termination of refractory ventricular tachycardia by a combination of intravenous sotalol and overdrive ventricular pacing. 1987

M J Llewellyn, and D R Ramsdale

Right ventricular overdrive pacing is an effective method for termination of ventricular tachycardia. This may be due to alteration in conduction rate, conduction pathways, or refractory periods of myocardial tissue. The procedure can be facilitated by antiarrhythmic drugs which increase tachycardia cycle length. Sotalol possesses beta-blocking action, has been shown to increase duration of action potentials and refractory periods throughout myocardial tissue and accessory pathways, and can suppress and prevent recurrent malignant ventricular arrhythmias. We describe two cases with ventricular tachycardia which were terminated transiently by cardioversion, but were resistant to various antiarrhythmic drugs. Right ventricular overdrive pacing was used in both cases, but was only effective after the administration of intravenous sotalol. We conclude that the unique properties of sotalol may make it especially effective in this context. Caution is required because of the hypotensive and negative inotropic actions of beta blockers, and possible acceleration of ventricular tachycardia by overdrive pacing.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002304 Cardiac Pacing, Artificial Regulation of the rate of contraction of the heart muscles by an artificial pacemaker. Pacing, Cardiac, Artificial,Artificial Cardiac Pacing,Artificial Cardiac Pacings,Cardiac Pacings, Artificial,Pacing, Artificial Cardiac,Pacings, Artificial Cardiac
D003131 Combined Modality Therapy The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used. Multimodal Treatment,Therapy, Combined Modality,Combined Modality Therapies,Modality Therapies, Combined,Modality Therapy, Combined,Multimodal Treatments,Therapies, Combined Modality,Treatment, Multimodal,Treatments, Multimodal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013015 Sotalol An adrenergic beta-antagonist that is used in the treatment of life-threatening arrhythmias. Darob,MJ-1999,Sotalol Hydrochloride,Sotalol Monohydrochloride,MJ 1999,MJ1999
D013610 Tachycardia Abnormally rapid heartbeat, usually with a HEART RATE above 100 beats per minute for adults. Tachycardia accompanied by disturbance in the cardiac depolarization (cardiac arrhythmia) is called tachyarrhythmia. Tachyarrhythmia,Tachyarrhythmias,Tachycardias

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