Heart Rate: I have been on Sotalol (2 x... - AF Association

AF Association

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Heart Rate


I have been on Sotalol (2 x 40mcg per day) for just over a month and have found that it has reduced my heart rate considerably. At rest, it ranges from about 49-52; when walking about, maybe 58-64. When Ivspoke to a GP about this this afternoon she said that this was too slow and wants me to reduce the Sotalol to 2x 20mcg per day. This will involve breaking the tablet in half as there is no tablet less than 40mcg. She says that the heart should beat in the range 55-100. I wondered what other people’s heart rates were with Afib and if they had been similarly advised. I have PAF and have found that my heart tends to beat irregularly rather than very rapidly.

10 Replies

Hi I’ve just been told I have to go on solotol before my cv in September should I be worried ? I feel a bit apprehensive !!!

Samazeuilh in reply to Edm174

There is quite a lot of information on Sotalol and the problems

associated with it in the Wiki article here: en.m.wikipedia.org/wiki/Sot...

Before I started taking Flecainide and a beta blocker my normal heartrate was around 70 but when in AF it was usually between 120 and 200. Whilst I have been taking drugs I’ve had no AF and my resting heartrate is in the mid 60’s.

Your rate of 49 to 52 sounds slightly low to me - and it probably goes even lower when you sleep.


To start with sotalol is not recommended for AF here in UK although one or two EPs do still use it it some rare cases. It has both beta blocking and rhythm control qualities.

Normal heart rate is considered to be between 60 and 100 but generally expected to be around 70. Very fit athletes may have much lower rates and I once encountered an ex lifeboat coxswain with a resting rate of 36 who was quite healthy and happy. Personally (and I am not a medic) I think your GP is over reacting unless you are feeling faint or dizzy but I would take more notice of what your consultant says as presumably it was they who prescribed the drug. Why not contact their secretary and ask the question.

I am on Sotolol 120mg am and pm at rest I am at 58 to 64, after a bit of house work or in the garden 68 to 77 but I have still been admitted to A&E 5 times this year reaching 264 but I suffer with severe anxiety and panic attacks .

I was told not to worry providing the rate does not drop below 40, so as Bob suggested contact the proscriber don’t change unless you really have to because the more you mess with meds the less effective they become


I was on Sotalolol for a while but it didn't help. Now I'm on Nebivolol 2.5mg daily and Flecainide 50mg twice daily. My resting heart rate is around 44. I have an implanted loop recorder which recently detected a heart rate of 240. Fortunately I was asleep at the time. I am having an ablation on 4 September. Hope it works!

I am on 80mg and 120mg Sotalol at night, the increase of 40mg on the night time one was to help sleeptime high blood pressure , but I have since been diagnosed with severe sleep apnea so I am going back to 80mg x 2. My doctor was concerned as my HR was reaching the early 40's during the day but the cardiologist wasn't concerned as it was averaging out at 50. I have been on it for 3 years. Hope that helps.

I am on Sotalol but following my proposed ablation will stop taking it and use it only if af returns as it is proven to work for me. Prescription of sotalol seems to be on the increase and I know of others that take it for af, across various geographical areas in UK, so Bob I think you will need to revise your opinion of only one or two EPs favouring it.

Hi Samazeuilh, I am on Sotalol 40 mg twice daily. Here in the US I have to break my 80 mg pills in half which don’t always break evenly but I am getting better at it. I can’t imagine having to cut them in half again to get 20 mg. If you look back at my first introduction post, you will see my heart rate runs low and always has even before starting Sotalol. My pulse is often between 40 and 50 and doc is okay with that. It even drops in the 30’s during sleep in the early morning hours. I also have tachy-brady syndrome so that keeps heart rate low. One of my sisters and both my daughters have naturally low heart rates so it runs in the family and has never been a problem.

The problem as I see it, is blanket medication!

Everyone has an opinion, unfortunately they are not looking at the overall big picture. We all know that it is considered the norm to have a pulse/heart beat of 60 - 100 (that is a very big variation). With that in mind - why do we accept less ie say hign 40s/low 50s (as do I)?

We imo, should be aiming for what our body HR used to be , ie in my case 72ish (allowing for age etc ).

Why? I would say in order to get back to some order of being normal, aim for what used to be your HR prior to condition/allowing for age etc).

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