Key result
Sotalol-induced atypical Torsades de Pointes was reproducibly triggered only by programmed electrical stimulation in a patient with previously inducible monomorphic tachycardia.
Programmed electrical stimulation can reproducibly induce atypical Torsades de Pointes in patients on sotalol therapy.
Sotalol may induce atypical torsades during programmed stimulation in select patients; single case leaves open broader risk-stratification utility.
We present a patient with sotalol-induced polymorphic ventricular tachycardia that was seen only with programmed ventricular stimulation. Electrophysiologic studies performed prior to initiation of sotalol therapy revealed inducible monomorphic ventricular tachycardia. Possible underlying electrophysiologic mechanisms are discussed.
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Krishnan et al. (1997) studied this question. Sotalol-induced atypical Torsades de Pointes was reproducibly triggered only by programmed electrical stimulation in a patient with previously inducible monomorphic tachycardia.
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