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Does Tikosyn work better than Sotalol for patients with atrial fibrillation?

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Posted on Fri, 18 May 2018
Question: I have atrial fibrillation and a low pulse rate (45 - 55) when at rest. I can get it into the mid 90's when exercising. I'm 73 years old. My cardiologist wants to implant a pacemaker and is talking about using either Tikosyn (Dofetilide) or Solulol. I have 2 questions. If I have a pacemaker why more medicines and which of the two medicines mentioned would work best.
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Answered by Dr. Rishu Saxena (1 hour later)
Brief Answer:
Please go through the detailed answer.

Detailed Answer:
Hi sir,
Thanks for posting the query on this platform.
I have read your question in detail and I understand your concerns.

A pacemaker is a device inserted into your heart to increase your heart rate when you are in severe bradycardia.It works on battery and after inserting it into heart its programmed to function only when your heart reaches a minimum heart rate (this heart rate range is programmed by a programmer).

The pacemaker does not work 24 hours as its a battery operated machine and could be used only for small intervals(otherwise would lead to battery drainage in few weeks). Therefore medications are always given whenever pacemaker is implanted. However when medication can’t control your beats and they reach below the programmed cut off; pacemaker starts working and paces your heart by generating impulses.

Dofetilide and sotalol both are good for atrial fibrillation however as you are a case of AF with bradycardia I won’t prefer giving you sotalol as its a beta-blocker and beta blockers reduce heart rate. On the other hand, dofetilide is safe antiarrhythmic does not cause bradycardia and has effects on left ventricular functions also.Overall it increases the probability of obtaining and maintaining sinus rhythm in patients with structural heart disease.

Hope I cleared your doubt.
Feel free to ask any further doubts.
Thank you!


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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Does Tikosyn work better than Sotalol for patients with atrial fibrillation?

Brief Answer: Please go through the detailed answer. Detailed Answer: Hi sir, Thanks for posting the query on this platform. I have read your question in detail and I understand your concerns. A pacemaker is a device inserted into your heart to increase your heart rate when you are in severe bradycardia.It works on battery and after inserting it into heart its programmed to function only when your heart reaches a minimum heart rate (this heart rate range is programmed by a programmer). The pacemaker does not work 24 hours as its a battery operated machine and could be used only for small intervals(otherwise would lead to battery drainage in few weeks). Therefore medications are always given whenever pacemaker is implanted. However when medication can’t control your beats and they reach below the programmed cut off; pacemaker starts working and paces your heart by generating impulses. Dofetilide and sotalol both are good for atrial fibrillation however as you are a case of AF with bradycardia I won’t prefer giving you sotalol as its a beta-blocker and beta blockers reduce heart rate. On the other hand, dofetilide is safe antiarrhythmic does not cause bradycardia and has effects on left ventricular functions also.Overall it increases the probability of obtaining and maintaining sinus rhythm in patients with structural heart disease. Hope I cleared your doubt. Feel free to ask any further doubts. Thank you!