Sotalol

September 5, 2001

In a message dated 9/5/2001 2:16:32 PM Pacific Daylight Time,

oh@... writes:

<< He prescribed a beta-blocker - Sotalol - 40 mgs x twice daily! Does anyone

have knowledge of this drug. The side-affects look horrendous and having

beaten a benzodiazepine problem less than 12 months ago, I am reluctant to

go back on mood altering medication. >>

Oliver,

I am sorry that your hopes of cure through ablation were dashed. When my

doctor wanted to prescribed Sotalol for me two years ago, I did some research

on the drug and conducted an informal survey on the Internet through the Maze

Board and also through sci.med.cardiology. Out of about 50 respondents only

four said that Sotalol had worked for them. One of those was a man named

Wendt (I think) who has taken Sotalol for more than a year now. He

has had no side effects and has stayed in sinus. (You could probably get his

e-mail address on the Maze Afib Board, I think, or I could find it for you.)

Most other respondents complained that Sotalol caused depression, numbness

and tingling in extremities, dizziness, too slow heart rate, and headaches.

(Sotalol is not a mood altering drug. My cardiologist said that it is like a

beta blocker but with electrophysiological effects.)

None of these effects seemed insurmountable to me, but I was more concerned

about the potential of Sotalol to cause Torsades Des Pointes, a dangerous

rhythm. However, my doctor told me that statistics show that this rhythm

will occur within the first two to four days if at all. For this reason one

should be hospitalized to start Sotalol so that emergency measures may be

instituted if dangerous rhythms occur. If Torsades does not occur initially,

it is unlikely to occur later. Most people with whom I have corresponded

have not have serious problems with Sotalol but have stopped the drug because

it wasn't effective.

I would not be as afraid now to take Sotalol as I was when my doctor

initially suggested it. If I were having problems with my afib, I might

consider trying it, but my new cardiologist said that he would want to give

me Flecainide rather than Sotalol if I needed a drug from that class because

Sotalol is much more effective with men than with women.

Whatever you decide, I wish you good luck.

in Seattle

September 5, 2001

Dear Group

I had my long awaited appointment with the cardiologist today. You may

recall I was all ready to agree to having an ablation. Well, the Consultant

was not there and I had to see one of his Registrars. He told me that

ablation was not a good option, as it was only less than 50% successful and

is still very much in the development stage. In fact only 5 selected

patients have been ablated at this huge regional hospital. He thought I was

referring to the ablation where the ventricles are isolated completely and a

pace-maker inserted to take over - which apparently is very successful but

not suitable for my AF!

He prescribed a beta-blocker - Sotalol - 40 mgs x twice daily! Does anyone

have knowledge of this drug. The side-affects look horrendous and having

beaten a benzodiazepine problem less than 12 months ago, I am reluctant to

go back on mood altering medication. He was emphatic that Warfarin is most

important to counter the risk of stroke. This is the only medication I

currently use.

Sorry to be so glum, but having geared myself up to agreeing to an ablation,

I now feel very disappointed and deflated. Your advice and experience would

be much appreciated.

Kind regards,

Oliver

September 5, 2001

Hi, Oliver,

Maybe you need to wait and see the " real " doctor to discuss

ablation. A second opinion couldn't hurt, esp. if a registrar is a

doc in training.

I have to say my gut feeling from reading about people's experiences

here is that ablation for afib is improving rapidly, but myself I

would give it a year or two to see what things are like with it then

if I could wait.

Sotalol is a serious med, not just a relatively benign beta blocker.

www.rxlist.com says " Sotalol is not appropriate for everyone with

irregular heartbeats. If you have atrial fibrillation (a specific

type of irregular heartbeat), you and your doctor should carefully

discuss the benefits and risks of sotalol and whether your symptoms

are troublesome enough for you to start taking sotalol. In some

patients treated with sotalol for atrial fibrillation, sotalol may

cause a different type of abnormal heartbeat that can be dangerous,

and in rare instances can even cause death. "

I don't know if the doses are comparable, but if I were to take 80 mg

of toprol, my beta blocker, I would probably be in a coma. I have

trouble tolerating 25 mg, or even 12.5 mg.

I don;t remember where you are with meds - if dofeltilide is a

possibility?

Trudy

September 5, 2001