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Effect of metoprolol and d,l-sotalol on microvolt-level T-wave alternans

Results of a prospective, double-blind, randomized study

^a Department of Medicine, Division of Cardiology, J.W. Goethe University, Frankfurt, Germany

View larger version (15K): [in a new window]   Figure 1 Study protocol. EP = electrophysiologic; TWA = T-wave alternans; VF = ventricular fibrillation; VT = ventricular tachycardia.

View larger version (60K): [in a new window]   Figure 2 Reproducibility of T-wave alternans (TWA) analysis. (A) TWA amplitudes (alternan voltage [Valt]) at two repetitive drug-free baseline measurements in 12 patients. (B) Representative TWA recordings in a patient with stable TWA amplitutes (Valt) at repetitive drug-free measurements (NS = not significant). BPM = beats per minute; HR = heart rate.

View larger version (57K): [in a new window]   Figure 3 (A) Changes in heart rate following drug administration. (B) Changes in ventricular effective refractory periods following drug administration. (C) Changes in T-wave alternans (TWA) amplitude following drug administration (Valt) in patients with d,l-sotalol (dark bars) and metoprolol (gray bars). (D) Representative example of a patient with a significant decrease in Valt in nearly all electrocardiographic leads following administration of d,l-sotalol (left: before drug administration; right: after drug administration). BPM = beats per minute; HR = heart rate.