Survival With Oral d-Sotalol

Pratt CM, Camm AJ, Cooper W, Friedman PL, MacNeil DJ, Moulton KM et al. Mortality in the Survival With ORal D-sotalol (SWORD) trial Wliy did patients die Am J Cardiol 1998 81 869-76. 

Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF, Pitt B, Pratt CM, Schwartz PJ, Veltri EP. Effect of d-sotalol on mortality m patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. Lancet 1996 348(9019) 7-12. Erratum in Lancet 1996 348(9024) 416. 

Despite the discouraging results of the CAST, post-MI patients with complex ventricular ectopy remain at risk for death. Other drugs besides type Ic drugs have been studied, including sotalol. Sotalol is marketed as a racemic mixture of a D- and L-isomer both are type in potassium blockers, but the L-isomer has /3-blocking actions. Chronic therapy with D-sotalol was studied in patients with remote MI complicated by complex ectopy in the Survival With Oral D-Sotalol (SWORD) trial. Unlike in the CAST, D-sotalol treatment was not designed to cause PVC suppression, yet (as in the CAST) the trial was halted prematurely because of excessive mortality in the treatment arm. Again, the presumed reason for this observation was D-sotalol-related pro arrhythmia. Currently, only two antiarrhythmic... 

Similar to CAST, the SWORD (Survival With Oral d-Sotalol) trial investigated whether an antiarrhythmic drug affected mortality. SWORD used d-sotalol, a class III antiarrhythmic drug without substantial beta blocking... 

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