ES Safety of outpatient commencement of sotalol
Executive Summary
Suraya H. Kamsani
Suraya H. Kamsani, Melissa E. Middeldorp, Glenda Chiang, Maria Stefil, Shaun Evans, Mau T. Nguyen, Elnaz Shahmohamadi, Jessica Qingying Zhang, Kurt C. Roberts-Thomson, Mehrdad Emami, Glenn D. Young, Prashanthan Sanders. Published: Heart Rhythm O2. 17 May 2024 epub
Background
Sotalol is a medication used to treat irregular heartbeats, such as atrial fibrillation. Because it can sometimes cause serious side effects, like dangerous changes in heart rhythm, doctors usually start this medication while patients are in the hospital so they can be closely watched. This study wanted to find out if it’s safe to start sotalol while patients are being treated at regular outpatient clinics instead. Researchers reviewed 15 years’ worth of medical records (from 2008 to 2023) from several clinics. They focused on patients who began taking sotalol outside the hospital and were monitored with regular heart tests (called electrocardiograms or ECGs) on day 3, day 7, after one month, and as needed.
Key Findings:
Patient Information
- A total of 880 people started taking sotalol in outpatient settings. Most had heart rhythm issues like atrial fibrillation or flutter (about 87%).
Safety Results
- Sotalol slightly lengthened a part of the heartbeat measured by doctors (called the QTc interval), which is normal and expected. For most people, this change stayed within safe limits. Only about 1% of patients had a concerning increase, which could raise the risk for serious rhythm problems. However, no one in the study experienced severe heart issues, passed out, or died within the first month of treatment.
Adverse Effects
- A small number of people had to stop or lower their dose due to minor side effects, such as a slow heart rate or feeling short of breath. In total, 41 patients stopped taking the medication within the first month because of various side effects.
Conclusion
Starting sotalol outside of the hospital appears to be safe for most patients, as long as their heart is carefully monitored during the first few weeks.
