Original Research
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction: Intravenous (IV) sotalol is currently FDA approved for the maintenance of normal sinus rhythm in patients with symptomatic atrial fibrillation/atrial flutter. Administering an IV loading dose of sotalol before switching to the oral maintenance regimen can achieve steady state plasma concentrations within 1 day, compared to 2-3 days with oral therapy. Due to the potential reduction in hospital length of stay, IV sotalol was added to formulary with strict monitoring criteria and documentation requirements.
Research Question or Hypothesis: Investigate the clinical outcome, utilization patterns, and adherence to approved restrictions for use criteria for intravenous sotalol at Saint Luke’s Hospital of Kansas City.
Study Design: Single center, retrospective, medication use evaluation
Methods: Adult patients were included if they received IV sotalol from November 1st, 2021, to April 6th, 2023. The primary outcome was hospital discharge within 24 hours of admission. Secondary outcomes included hospital discharge within 48 hours of admission and adherence to required components of IV sotalol monitoring and documentation.
Results: A total of 42 patients underwent IV sotalol loading. A majority (60%) were male, with a median age of 71 years old. The most common indication for IV sotalol was atrial fibrillation/atrial flutter (88%). No patients were discharged within 24 hours of admission; however, 39 patients (93%) were discharged within 48 hours of admission. IV sotalol was well tolerated, with no observed infusion interruptions due to hemodynamic instability or QT prolongation. A total of 38 patients (90%) were discharged in sinus rhythm, though 18 patients (47%) underwent cardioversion. Adherence to restrictions for use criteria was poor, with only 1 patient (2%) having met all required documentation requirements.
Conclusion: Intravenous sotalol was well tolerated, with a majority of patients discharged within 48 hours of admission. Opportunities to improve adherence to restrictions for use criteria at our institution remain.
Presenting Author
Sam Menner PharmD CandidateSaint Luke's Hospital of Kansas City/Mid America Heart Institute
Authors
Terrence Brown PharmD, BCPS, BCCP
Saint Luke's Hospital of Kansas City/Mid America Heart Institute
Charles Hayes III PharmD, BCPS, BCCP, FACC
Saint Luke's Hospital of Kansas City/Mid America Heart Institute
Jack Pluenneke PharmD
Saint Luke's Hospital of Kansas City/Mid America Heart Institute