Sotalol: A rescue drug in the face of life-threatening refractory ventricular tachycardia.
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Date
2014-04
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Abstract
We describe postoperative refractory ventricular tachycardia (VT) in a patient following aortic and mitral
valve replacement. Following an uneventful separation from cardiopulmonary bypass with dobutamine, the
patient developed recurrent VT, 4 hours into the postoperative period. The VT did not respond to standard
doses of xylocard, magnesium and amiodarone. Electrolyte and acid base parameters were normal.
Multiple cardioversions failed to revert back to a stable rhythm. Intra‑aortic balloon pumping was instituted
and overdrive right ventricular pacing was unsuccessful. Following intravenous sotalol 80 mg, the VT came
under control and reverted to a nodal rhythm, which required atrial pacing for the next 8 hours. Oral sotalol
therapy was continued at 40 mg daily. The VT did not recur.
Description
Keywords
Amiodarone, Cardioversion, Double valve replacement, Refractory ventricular tachycardia, Sotalol
Citation
Kandasamy Ashok, Arumugham Sukumar, Krupanandha Harshavardhan, Reddy Bhaktavatsala. Sotalol: A rescue drug in the face of life-threatening refractory ventricular tachycardia. Annals of Cardiac Anaesthesia. 2014 Apr; 17(2): 170-172.