breathlessness, exercise and sotalol

[SingingGardener]

I'd be grateful to know of others' experiences of sotalol. I started 2 weeks ago on 80mg twice daily and since then have not been able to do my usual fairly brisk pace of daily walking for 20-30 minutes without feeling out of breath and exhausted.

I moved from 2.5 mg bisoprolol having agreed to go on the waiting list, 6-9 months for an ablation, and the other option, amiodarone, I didn't like the sound of the side effects at all.

I've had PAF for 12 years, with episodes which resolved themselves after a few hours, until 2 years ago since when they have increased in frequency and lasted longer. Then since summer 2022 I've had two episodes lasting nearly a week and several of a few days so I was referred to cardiology. I saw an arrhythmia nurse who explained the options available and since then have had 2 phone conversations with another arrhythmia nurse and seen my GP once.

The all only say that perhaps I will adjust to the sotalol. What do you think?

[Paulbounce]

Hi SG.

I'm on Sotalol.

You wrote.......

'The all only say that perhaps I will adjust to the sotalol. What do you think?'

Hmmm, let me think about this one ?????

The computer says............

Yep - it's highly likely your body will adjust. It might not happen overnight so give it a few months maybe less. 6 weeks is a good starting point.

It worked for me.

Paul

PS - this is not medical advice but just based on my own experience.

[SingingGardener in reply to Paulbounce]

Thank you. I'll try being patient!

I'm relieved the sotalol jerked me out of AF after the second tablet and grateful to be in sinus rhythm at the moment but not used to getting so tired and breathless on a small amount of exercise.

[Paulbounce in reply to SingingGardener]

I'll try being patient

Nail and head

Paul

[mjames1]

Is flecainide an option for you? Requires a structurally sound heart. Side effect profile is a lot better according to many.

Jim

[SingingGardener in reply to mjames1]

Thanks, apparently it's not an option as I had a CT scan 2 years ago which found some plaque developing in a coronary artery so I've been taking atorvastatin since then.

[mav7]

Agree with Paulbounce

Give your body time to adjust to the effect of Sotalol. Often common among medications for afib.

In the interim, continue to monitor your heart rate and blood pressure.

[SingingGardener]

Thank you all for your comments. Reassuring to know I need to persevere and be patient!

[Ppiman]

I think their experience is what I would go by and give the drug longer. Drugs such as sotalol and flecainide can increase the QT interval in your heart altering its conduction slightly. If you already have a rather longer QT interval, then the drug might cause symptoms until the heart adjusts.

Perhaps you could ask if this is the cause (the QT interval is picked up on an ECG and is the brief time between the start of the ventricular contraction called the "Q" wave on an ECG and the end of the ventricular contraction the "T" wave. I seem to have a rather longer QT interval than that which allows me to be given drugs such as flecainide and the only option would have been amiodarone (which has been clearly when to be safe in low dose, by the way: pubmed.ncbi.nlm.nih.gov/323... ) or an ablation.

Steve

[Tapanac]

I was on solatol for a few months and couldn’t get on with it st all. I’m always breathless since, but now on flecainide and 1.25 bisoprolol the afib and tachycardia have calmed down

Hope you feel better

Pat

[Tricia239]

Hello, I have been taking Sotalol for quite some time and I’m now on double your dose. Unfortunately I also suffer with similar breathlessness. However when I mention it to the Cardiology team they seem reluctant to blame Sotalol, but equally can’t provide another reason. Like you I am pleased to be in NSR as I am very symptomatic and my attacks last for weeks. I had my second ablation at the end of November but sadly that doesn’t seem to have helped. I could add a few choice words but I had better not on here, but it really is a bit of a b-gg-r! I think you and your body will adjust and to my mind it is the lesser of two evils - oreven, least of several. Good luck

[MarkS]

I was on sotalol for 2 years. It was pretty bad, it damped my heart rate and I was puffing up hills which I could normally take in my stride. When I came off it, it was like I was a new man! If it doesn't stop the AF then I would stop it as it could do more damage than benefit, see

cks.nice.org.uk/topics/atri...

It should only be prescribed by specialists. I went on to diltiazem for rate control which was much better.

[WowWow in reply to MarkS]

Same here, my new Cardiologist took me off it, my pulse was below 40 at time!

[marcyh]

I was on sotolol for a week and that was all I could manage. I, too, was short of breath, it slowed my heart rate too much and I nearly passed out in a lab. Good advice to monitor your heart rate and BP.

[Fryguy]

Hi , I am on the same dosage of sotolol as you and it has given me a rash and I get nauseous on it. Like you said it has reduced my exercise capacity greatly and that is the most frustrating part for myself . I wish there was more options for myself, as I am told it is this or amiodarone and I won't take that drug ever again in my experience. I am waiting on an electrophysioligist in Canada but it takes years to get in and an ablation takes around 4 years 🤮🫤🙈.. I still have afib whenever I exercise or do strenuous work ...All the best to you ❤️

[SingingGardener in reply to Fryguy]

Thank you for your reply and all the best to you 😊

[TouchVeena]

I experienced breathlessness and stomach cramps from sotalol. I put up with it for about a month, and then went back to metoprolol. Feel much better now although I still occasionally get a tightness in my diaphragm.

[Janith]

l have been on sotalol for perhaps four years … zero issues … l do get chilly in the evenings easily but that’s it. It seems to be an excellent product that has been around for a long time. Give it some time. Incidentally , l exercise on a daily basis … never tired or short-winded ! Best, Jan

[Kudos4me]

I was on Sotalol briefly a week or so. It triggered my practically non-existent asthma similarly to what many have described but more intensely. Ironic it is contraindicated for people with asthma. So are many HBP meds... by the time the ablation was done, 5 cardioversions could not get me out of afib. Not my Dr's choice but surgery was done 100% in afib. He said he enjoys & thrives on challenges 😊 I said Hi meet your challenge! He was and is awesome! We also found my groin veins take the scenic route to my heart, not straight to it like most people.