This case report highlights the risk of sotalol-induced torsade de pointes, particularly in patients with pre-existing Q-T prolongation.
Supports caution with sotalol in patients with QT prolongation; hypothesis-generating for differential risk versus pindolol in arrhythmia testing.
A case of sotalol-induced polymorphous ventricular tachycardia (torsade de pointes) is presented. The patient had moderately prolonged Q-T interval before medication with sotalol with further prolongation after application of this drug. Electrophysiological study during rechallenge with sotalol demonstrated a uniform ventricular tachycardia with a somewhat polymorphous onset; whether or not this tachycardia represented replication of the patient's spontaneous arrhythmia is questionable. Without antiarrhythmic drugs and during medication with pindolol ventricular tachycardia was not inducible.
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Rakovec et al. (1984) studied this question.
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