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Peer-reviewed veterinary case report

Treatment of ventricular arrhythmias with oral sotalol in four horses.

Journal:
Journal of veterinary internal medicine
Year:
2026
Authors:
Junge, Hannah K et al.
Affiliation:
Equine Department
Species:
horse

Plain-English summary

This study looked at four horses with a heart condition called sustained ventricular arrhythmias (VAs), which can cause serious problems if not treated. The horses were given a medication called sotalol by mouth, which is usually used to prevent other heart issues. Remarkably, all four horses showed improvement, returning to a normal heart rhythm or their previous condition without any negative side effects. This suggests that sotalol could be a good option for treating certain cases of VAs, especially when other treatments are not available or too expensive.

Abstract

Sustained ventricular arrhythmias (VAs) in horses can require medical intervention. Prompt pharmacological treatment is indicated when the arrhythmia leads to hemodynamic or electrical instability. Established antiarrhythmic treatment of VA in horses includes lidocaine and magnesium, administered parenterally. Other antiarrhythmic agents are used; however, concerns regarding adverse effects, financial restrictions, logistics of administration, and lack of access often limit their use. While anecdotal reports of oral administration of sotalol for treatment of VA in horses exist, sotalol has primarily been described for prevention of recurrent atrial fibrillation or suppression of supraventricular and ventricular ectopy. This case series describes 4 horses with sustained VA treated orally with sotalol. Successful conversion to a predominantly normal sinus rhythm or pre-existing atrial fibrillation was achieved without any adverse effects. Sotalol could be considered as a treatment option in selected, hemodynamically stable cases of VA, especially where other established treatment options are unavailable, ineffective, or unaffordable.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/42059463/