Other class III agents

Because of the increased use of amiodarone as a broad-spectrum antiarrhythmic agent there has been much interest in developing new class III agents without the side-effect profile of amiodarone in chronic use. Sotalol, a racemic mixture of D- and L-sotalol, is perhaps the most widely used but is limited by significant b-blocking activity. D-Sotalol has minimal b-blocking activity but has proved unsuccessful in the setting of high-risk postmyocardial infarction patients, with excess mortality in those taking active drug. Other agents such as dofetilide and ibutilide remain in development, but their ultimate clinical role remains to be determined.

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