Prevention

Consider adding one of the following: 

• amiodarone ^b
• metoprolol ^a
• sotalol ^a

Why?

• Patients on amiodarone have fewer shocks than patients on other anti-arrhythmics ^b
• Patients on sotalol have fewer shocks than on placebo, but there is no clear effect on mortality ^a
• Metoprolol is more effective than sotalol at preventing shocks, but there is no clear effect on mortality ^a

Metoprolol is more effective than sotalol at reducing shocks from implanted defibrillators

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
implantable defibrillator for VT a	sotalol	placebo	defibrillator shock at 12 months	48%	38% (17% to 54%)	5 (3 to 13)
implantable defibrillator for VT a	sotalol	metoprolol	defibrillator shock	20%	-140% (-410% to -15%)	-4 (-14 to -20)