WASHINGTON, DC—For the prevention of supraventricular tachyarrhythmia after cardiac surgery, sotalol, a Class II and III antiarrhythmic agent, appears to be as effective as amiodarone but superior to beta-blockers. Findings from this study were presented at the ACC.17 Scientific Session.

Given that supraventricular arrhythmias may be common after cardiac surgery, researchers from Creighton University School of Medicine in Omaha, NE, aimed to compare the efficacy of sotalol to other drugs used to prevent arrhythmias (eg, beta-blockers, amiodarone). They did a literature search which yielded six randomized controlled trials that included 1,328 patients. Five studies compared sotalol to beta-blockers while two compared sotalol with amiodarone.

“We then synthesized the data using STATA 13 software to estimate the risk ratio (RR) and 95% CI for occurrence of these arrhythmias,” lead author Arun Kanmanthareddy, MD, MS, explained.

In the sotalol and beta-blocker groups, supraventricular arrhythmias occurred in 14% and 23% of patients, respectively. The incidence of arrhythmias was lower for the sotalol group compared to the beta-blocker group (RR 0.69, 95% CI 0.53–0.91).

In the sotalol and amiodarone groups, supraventricular arrhythmias occurred in 28% and 23% of patients, respectively. No difference in the incidence of arrhythmias between these two groups was noted (RR 1.18, 95% CI: 0.78–1.78). Overall, sotalol when compared to other antiarrhythmics for post-surgical supraventricular arrhythmias demonstrated a RR of 0.80 (95% CI: 0.61, 1.06).