Tachycardia: Sotalol decreased recurrence.

Clinical bottom line (level 1b)

  1. Patients with paroxysmal supraventricular tachyarrhythmias who were given sotalol 80 mg, were less likely to have a recurrence of the arrhythmia than those given placebo (NNT = 3 at unknown) .
  2. Patients given sotalol 160 mg were less likely to have a recurrence of arrhythmia, than those given placebo (NNT = 2 at unknown)
Wanless et al: American Heart Journal 1997; 133: 441-446
Expires August 2004

The study

Double-blinded ?concealed randomised trial with intention-to-treat
Setting: 17 centres in the UK, USA, Switzerland and Austria

80 patients ambulatory, with a documented history of recurrent symptomatic paroxysmal supraventricular tachycardia

Excluded if
  • aged <18 years or >80 years old
  • <40 kg and >100 kg body weight
  • uncompensated congestive heart failure
  • asthma
  • chronic obstructive airways disease
  • second or third degree atrioventricular block
  • recent myocardial infarction (<1 month)
  • recent coronary artery bypass graft surgery (<2 months)
  • unstable angina pectoris
  • bradycardia (<50 beats per minute)
  • sick sinus syndrome
  • prolonged QTc interval (>0.45 seconds)
  • systemic hypertension (diastolic pressure >115 mmHg)
  • electrolyte imbalance
  • concomitant antiarrhythmic therapy


    • Control Group: (n = 26, 26 analysed): placebo
    Experimental Group: (n = 23, 23 analysed): sotalol 80 mg twice daily
    Experimental Group: (n = 31, 31 analysed): sotalol 160 mg twice daily
    There were 3 phases to the trial: (1) washout-no antiarrhythmic treatment for at least 2 days; (2) baseline phase-each patient was monitored to determine the frequency of the tachyarrhythmia, lasting several weeks; (3) double blind phase- 1 week dose-escalation period followed by 2 study periods of equal duration to that assigned to the patient during the baseline phase.
    100% followed for ?
    Outcome notes:
    • no recurrence of supraventricular tachycardia (sotalol 80 mg as test drug) : assessed using ECG and documentation of symptoms

    The evidence

    Outcome Time to outcome CEREERRRR
    (95% CI)    		ARR
    (95% CI)    		NNT
    (95% CI)
    no recurrence of supraventricular tachycardia (sotalol 80 mg as test drug) unknown 5
    (19.2%)    		 11
    (47.8%)    		 -149%
    (-509% to -2%)    		 -28.6%
    (-54.0% to -3.17%)    		 3
    (2 to 32)
    no recurrence of supraventricular tachycardia (with sotalol 160 mg as test drug) unknown 5
    (19.2%)    		 21
    (67.7%)    		 -252%
    (-703% to -54%)    		 -48.5%
    (-70.9% to -26.1%)    		 2
    (1 to 4)

    Citation

    1. Wanless RS, Anderson K, Joy M: Multicenter comparative study of the efficacy and safety of sotalol in the prophylactic treatment of patients with paroxysmal supraventricular tachyarrhythmias. American Heart Journal 1997; 133: 441-446
    Contributor: Clare Wotton and Bob Phillips, August 1999
    Reviewer:

    Clinical Question.
    Patient paroxysmal supraventricular tachyarrhythmia
    Intervention or Exposure sotalol
    Comparison placebo
    Outcome recurrence of tachycardia