Beta Blockers, Sotalol, or Amiodarone for the Treatment of Malignant Ventricular Arrhythmias?

In patients with malignant ventricular tachyarrhythmias the impact of drug therapy on total mortality has been difficult to evaluate with certainty because placebo-controlled studies could not be performed for ethical reasons. However, current clinical data indicate a need for a greater use of drugs that prolong repolarization, such as amiodarone and sotalol (class III of antiarrhythmics), than agents that delay conduction, such as sodium channel blockers (class I) (1–5). There is also increasing evidence that sympathetic inhibition represents a fundamental feature in the treatment of patients with ventricular tachycardia (VT) and ventricular fibrillation (VF) (4).