What is your approach to maintenance of sotalol in terms of drug monitoring and duration of therapy for outpatients who remain in normal sinus rhythm?  

I have a healthy respect for the proarrhythmic potential of sotalol. I routinely load and increase the dose in the hospital setting. Not too dissimilar to dofetilide. I avoid as much as possible other drugs that prolong the QT interval and I use caution with other drugs that slow the HR. I monitor E...

I pretty much agree with Dr. Courson. I almost always load/change the dosage of sotalol in the hospital. I will monitor the patients closely thereafter, with frequent assessment of renal function and ECG.

I agree that pro arrhythmics need to be respected with regard to their potential adverse effects. Monitoring for 2 1/2 to 3 1/2/ lives would allow for adequate time to determine if there are significant proarrhythmia effects however long-term monitoring should be ascertained as well as monitoring of...