Heart 1998;79:518-520 ( May )
Case report
Sotalol associated polymorphic ventricular tachycardia and
coronary spasm
Department
of Cardiology, Papworth Hospital, Papworth Everard, Cambridge CB3 8RE,
UK
Correspondence to: Dr Grace. email: ag{at}mole.bioc.cam.ac.uk
Accepted for publication 13 January 1998
Sotalol may induce torsade de pointes through cardiac action
potential prolongation, but a proarrhythmic effect secondary to its 
blocking action has not been reported. A 54 year old man presented with
symptoms of angina and presyncope, subsequently demonstrated to be
associated with coronary spasm. Treatment with sotalol exacerbated his
symptoms and resulted in recurrent polymorphic ventricular tachycardia
with a pattern indistinguishable from that caused by a class III
action. Following sotalol withdrawal polymorphic ventricular
tachycardia resolved completely. Polymorphic ventricular tachycardia in
patients treated with sotalol may therefore not always be the result of
delayed repolarisation, but may be caused by adrenoceptor blockade.
© 1998 by Heart
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