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Feuerborn ML, Dechand J, Vadlamudi RS, et al. Protocol Development and Initial Experience With Intravenous Sotalol Loading for Atrial Arrhythmias. Crit Pathw Cardiol. 2023 Mar 1;22(1):1-4. doi:10.1097/HPC.0000000000000308

Dr. Feuerborn et al present an institutional protocol and retrospective review for patients treated with IV sotalol for atrial fibrillation/flutter at the University of Utah Hospital. The streamlined protocol was successfully implemented, and their initial experience suggests feasibility, safety, and tolerability while reducing hospitalization duration.

Highlights of Prescribing Information

Boxed Warning, Indications, and Important Safety Information


Sotalol can cause life threatening ventricular tachycardia associated with QT interval prolongation. To minimize the risk of drug induced arrhythmia, initiate or uptitrate intravenous sotalol in a facility that can provide continuous electrocardiographic monitoring and cardiac resuscitation [see Dosage and Administration (2.3) and Warnings and Precautions (5.1)].
Do not initiate intravenous sotalol therapy if the baseline QTc is longer than 450 ms. If the QTc prolongs to 500 ms or greater, reduce the dose or discontinue. (2.3)