Sotalol Started at Home

[usnimtz]

My daughter has had a-fib since she was 19. 1 ablation that failed after she got pregnant. Multiple meds and a cardioversion and she is in and out all the time. They started her on Sotalol 80mg 2x a day two days ago at home. I'm a retired nurse and have never heard of starting Sotalol at home. Today she had an EKG and it showed prolonged QT. They did NOT stop the Sotalol so I'm thinking it wasn't prolonged enough but they put her on a cardiac monitor and sent her home. She is now 33 years old. I'm scared to death she will go in cardiac arrest. She also had no labs drawn prior to starting. Has anyone else started this drug at home?

[BobD Volunteer]

Here in UK sotalol is seldom used but I do share your worry. Doesn't seem right to me.

[KipperJohn in reply to BobD]

Don’t know if you remember Bob but we had a discussion about sotalol a long time ago about it being removed from the NICE recommendations for AF. I was put on it without this knowledge by my local hospital and my EP , who is based elsewhere, put me back on metoprolol when I requested it.

[Karendeena in reply to BobD]

Hi Bob my EP (top Professor) put me on Sotalol having taken me off Flecainide and Bisorolol. I also have a friend who has had afib for 35 years and she is on Sotalol. Can you give me more information as to why is was supposed to be taken off recommendations please?

[BobD Volunteer in reply to Karendeena]

Sorry my only knowledge is that it is known as a dirty drug. I know a few EPs do use it but since it is not a mainstream prescription it is not common.

[Karendeena in reply to BobD]

Thanks BobD, I would have thought the Professor EP who I am under who is pioneering new ablation techniques (he had an article in the Sunday Times a while ago) wouldn't prescribe a drug that he thought would not be recommened as suitable

[Hidden]

I took Sotalol for paroxysmal atrial fibrillation for 8 years, without any problems that I am aware of. And yes I started it at home after an outpatient consultation with an experienced consultant cardiologist whom I saw privately.

Of course my experience has no bearing on your daughter’s use of Sotalol and I can’t speak to the use of Sotalol in the USA. I am in the UK. I am not a doctor.

[Karendeena in reply to Hidden]

Do you still take it Badger?

[Hidden in reply to Karendeena]

No, I stopped it after my failed second ablation. Being in permanent AFib now, I take nebivolol with apixaban.

[Karendeena in reply to Hidden]

What's nebivolol, never heard of it? I take apixaban

[SamuelJB in reply to Hidden]

Hi yes my experience has been the same and so far all is good control and stable no paroxysmal AF.....

[marcyh]

I'm in Canada, a senior, dx with PAF two years ago. Was put on Sotolol - at home. I was on it a week and symptoms kept getting worse - irregular heartbeat, heart rate into the 30s at night. At a lab I I got up to walk, got so short of breath I nearly passed out; could hardly put two words together. I called my AF clinic that day and asked to go off, they agreed right away. Went back on Eliquis.

[BobD Volunteer in reply to marcyh]

Eliquis is an anticoagulant not a heart rythm drug.

[marcyh in reply to BobD]

Right! Thanks. I was taken off propafenone and put back on. I wasn't taken off Eliquis.

[Cat04]

I'm in UK & started sotalol in hospital, a couple of days before going home. It took me out of AF and kept it away for the 2 years I took it prior to my ablation.

[Stucoo]

If you look at previous posts there are a few people on Sotalol. I have been taking it since September and started it at home.

[Karendeena in reply to Stucoo]

Me too Stucco, can't understand why it is said it's not used much in the UK, I know a few people on it

[Nan1]

I started Sotalol 40mg twice a day in 2014 at home after meeting with consultant.

[Windlepoons]

I started it at home after a telephone call from a cardiologist I had not spoken to before. It is keeping my AF at bay, after an adjustment to the dosage.

[MarkS]

I started sotalol at home and had no blood test before hand. I think that's the standard way in the UK. In the US I think they usually start you in hospital, but the cynic in me thinks that's because more profit is made that way!

[Clarrie]

I am in UK and have been on Sotalol for about six years and started on it at home with no ill effects.

[usnimtz]

Update. She is now on day 4 and so far is doing okay but she was in Afib yesterday. Her heart rate was at least controlled which it was not on metoprolol and flecainide. If this fails she will be getting another ablation. It runs in the family. My brother has had 6 ablations and cardioverted several times. Multiple medications and can't seem to get anything to work. Of course now he is 69 and has CHF.

[Karendeena in reply to usnimtz]

Hi there, it seems like your daughter is having similar effects to me. I had episodes of Afib with very fast heart rate, often around 170 bpm. All of this happened whilst on Flecainide and Bisoprolol. I paid to go an see a top Professor who is an EP and he put me on Sotalol, saying it would have been the first choice for me if he had seen me when I first started with afib last year. I, like you daughter, still get the episodes and they can go on for several days, however, although the heart rate is irregular (often dropping down to 50bpm) I don't get the racing heart any more. Mine also settled more when I had been on it for a couple of months

[cuore in reply to usnimtz]

There is hope for your daughter since she is so young. Pulsed Field Ablation is coming in a few years; it's in the trial stages. This technique ablates the source of the rogue electrical signal so there is no burning to create a scar. Also, there is not the destroying of healthy tissue. The success rate is very high. Do hope your daughter will benefit from it and/or other techniques to be developed.

[Karendeena]

Hi there, my EP (who is a top Professor) stopped my flecainide and bisoprolol and started me on Sotalol at home about 5 months ago. I am only on a low dose of 40mg twice per day but seem to be ok. I still get episodes but the heart rate is a lot slower, in fact down to 50 bpm on occasions and I feel very 'fluttery in my chest. I get anxious which I think just adds to the problem.My EP by the way is happy with me at the moment and says a heart rate around the mid fifties is good and that things are well controlled at the moment.

I am not medically trained but I have read that Sotalol tends to be better treatment the longer you take it.

[Cheddars in reply to Karendeena]

Hi there I allso take sotalol 80mg.twice a day been on it for nearly 2 years have not had any problems.

[Cheddars in reply to Cheddars]

Hi I take sotalol 80mg.twice a day been on it about 2 and a half years and it has been very successful so far..

[SamuelJB]

Hi Yes I have recently started Sotalol at home under direction of Cardiologist who is monitoring with loop recorder continuously. I assume he knows about elongated QT interval and it is safe to start this medication in my particular case. So far results are excellent AF gone heart stable on Abixaban as precaution as well. I would ask your Cardiologist to be sure it is safe hope things improve soon for you daughter.

[FrizzGrizz]

I was told it needs to be started in a hospital. Five doses is the protocol here. Two nights and three days. EKGs every 3 hours (at least twice per dose).