Home Sotalol Initiation for the Management of Atrial and Ventricular Arrhythmias Using Remote Electrocardiographic Monitoring.
Document Type
Article
Publication Title
JACC Clin Electrophysiol
Abstract
BACKGROUND: Sotalol is a class III antiarrhythmic drug used for the management of patients with atrial fibrillation to maintain sinus rhythm. Sotalol-induced QT interval prolongation can be proarrhythmic and is conventionally initiated in an inpatient setting where routine electrocardiographic (ECG) monitoring is available while sotalol reaches the steady state. The emergence of cellular-compatible home ECG devices, such as AliveCor's Kardia Mobile 6L, which offers 6-lead ECG, has made it possible to accurately measure QT intervals outside the hospital.
OBJECTIVES: This study aimed to evaluate the safety, feasibility, and patient adherence to protocol-driven, pharmacist-led outpatient sotalol initiation using the Kardia Mobile 6L for remote ECG monitoring and to compare these outcomes with patients completing inpatient sotalol protocol for initiation.
METHODS: Patients who underwent outpatient sotalol initiation through an antiarrhythmic clinic for the treatment of both atrial and ventricular arrhythmias over a period of approximately 3 years, from September 1, 2020, to June 16, 2023, were retrospectively reviewed and compared with a cohort of inpatients initiated on sotalol. The outpatient cohort had a minimum longitudinal follow-up of 90 days.
RESULTS: A total of 263 patients using the outpatient sotalol initiation protocol were compared with 28 age- and sex-matched inpatients who underwent inpatient sotalol initiation. The outpatient cohort included 179 men (68%), with an age of 68.8 ± 10.1 years, CHA
CONCLUSIONS: Outpatient initiation of sotalol through a protocol-driven, pharmacist-led antiarrhythmic clinic is feasible and safe, with high adherence rates in a diverse range of patients using personal remote ECG.
First Page
386
Last Page
396
DOI
10.1016/j.jacep.2024.10.003
Publication Date
2-1-2025
Recommended Citation
LaBreck, Megan E; Chopra, Nagesh; Robinson, Andrea; Billakanty, Sreedhar R; Fu, Eugene Y; Nemer, David M; Shah, Ankur N; Tyler, Jaret D; Ash, Cody; Farrah, Allyson; James, Jennifer; Murnane, Victoria; Loessin, Beth; Smith, Afton; Swinning, Jill; Badin, Auroa; and Amin, Anish K, "Home Sotalol Initiation for the Management of Atrial and Ventricular Arrhythmias Using Remote Electrocardiographic Monitoring." (2025). Heart and Vascular Articles. 75.
https://scholarlyworks.ohiohealth.com/heart-vascular-articles/75