sotalol v. atenolol

[dz911]

I am on atenolol for a fib following an ablation that "fixed" the atrial flutter. Although the atenolol is keeping me in sinus rhtyhm the Dr. thinks sotalol is a better choice for the long term. I have no side effects from the atenolol except some fatigue (I take 37.5mg bid). What I have read about sotalol is that it can lengthen QTinterval. How would you know that was happening other than an EKG or dropping dead?

[Michael J. McWilliams, M.D.]

Your doctor would admit you to the hospital for 72 hours to load sotalol.  The QT prolongation seen with sotalol occurs in the first 72 hours.  If your QT is safe after the drug loading, it is a safe drug.

If you are in sinus rhythm and your atrial fib is not frequent, you could always wait for it come back before you start it.  Metoprolol tends to cause less fatigue than atenolol.