High-dose sotalol is safe and effective in neonates and infants with refractory supraventricular tachyarrhythmias

Pediatr Cardiol. 2011 Oct;32(7):896-903. doi: 10.1007/s00246-011-0010-0. Epub 2011 May 8.


Our objective was to assess the efficacy and safety of high-dose sotalol in neonates and infants with refractory supraventricular tachycardia (SVT). SVT in neonates and infants can be refractory to primary therapies; therefore, secondary agents, e.g., sotalol, are often required to obtain control of SVT. Age-factor nomogram dosing of sotalol is widely used; however, our institution uses greater doses based on body surface area (approximately 150-200 mg/m(2)/d). A retrospective review of 78 inpatients receiving sotalol, after failing another antiarrthymic medication, at our institution from 2001 to 2008 was performed. Corrected QT intervals (QTc), 24-h Holter-monitoring results, and outpatient records were reviewed to assess safety and efficacy for patients ≤ 2 years of age. Median patient age at the time of initiation of therapy was 24 days (range 3-728). Forty-eight patients (62%) were neonates, and 36 (46%) had congenital heart disease. The median sotalol dosage was 152 mg/m(2)/day (range 65-244). The SVT of 70 patients (90%) was controlled with sotalol. No patients experienced significant QTc prolongation or proarrhythmia. Mean duration of follow-up was 3.3 ± 0.24 years. High-dose sotalol allows for safe and rapid control of refractory tachyarrhythmias in this young age group.

Publication types

  • Comparative Study

MeSH terms

  • Anti-Arrhythmia Agents / administration & dosage*
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Electrocardiography, Ambulatory / drug effects
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / complications*
  • Heart Defects, Congenital / diagnosis
  • Heart Rate / drug effects*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Sotalol / administration & dosage*
  • Tachycardia, Supraventricular / drug therapy*
  • Tachycardia, Supraventricular / etiology
  • Tachycardia, Supraventricular / physiopathology
  • Treatment Outcome


  • Anti-Arrhythmia Agents
  • Sotalol