Signal Averaged ECG Parameters following Administration of Sotalol in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy

Background:

Sotalol is the most effective anti-arrhythmic drug in patients with Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC).

Objective:

This retrospective study aimed to evaluate the effect of sotalol on Signal Averaged ECG (SAECG) parameters in patients with ARVC.

Methods:

This retrospective study was performed on 11 ARVC patients who were recruited from the cardiology clinic. SAECG was performed in all patients at baseline and six weeks after treatment with sotalol. To assess the effects of sotalol on SAECG, the three following parameters were taken into account: 1) filtered QRS duration, 2) duration of terminal QRS < 40 µv, and 3) Root Mean Square (RMS) voltage of terminal 40 ms. Patients with coronary artery disease, dilative or hypertrophic cardiomyopathy, congenital heart disease, and significant valvular heart disease were excluded from the study.

Results:

In total, 11 patients with confirmed ARVC were included. The mean age of the participants was 28 ± 11 years and all patients were male. History of syncope was reported in four patients, ventricular tachycardia in three patients, positive family history of cardiac disorders in two patients, and Epsilone wave in four patients. Besides, Implantable Cardioverter Defibrillators (ICDs) were implanted in five patients. No significant change was detected in the filtered QRS duration following the use of sotalol (P = 0.542). However, a significant reduction was observed in the Low Amplitude Signal (LAS) duration below 40 µv (P = 0.002). Additionally, a significant increase was found in the RMS voltage in the last 40 ms of the QRS (P = 0.043).

Conclusion:

Sotalol decreased the duration of terminal QRS < 40 µv. Because of this valuable effect, sotalol should be considered as the first-line therapy for treating ARVC patients.