Treatment of ventricular arrhythmias with oral sotalol in four horses.

Oral sotalol may be effective for treating stable ventricular arrhythmias in horses.

This case series presents four horses with sustained ventricular arrhythmias (VAs) treated with oral sotalol, a beta-blocker with class III antiarrhythmic properties. Ventricular arrhythmias in horses can compromise hemodynamic and electrical stability, necessitating pharmacological intervention. Traditional treatments include parenteral lidocaine and magnesium; however, these require intravenous administration and may be limited by cost, accessibility, or efficacy concerns. While sotalol has been anecdotally used orally in horses, its role has primarily been for atrial fibrillation prevention or suppression of ectopy rather than treatment of sustained VAs. In this series, all four horses achieved successful conversion to predominantly normal sinus rhythm or reverted to pre-existing atrial fibrillation without adverse effects. The findings suggest sotalol may be a viable oral alternative for treating hemodynamically stable ventricular arrhythmias, particularly when conventional treatments are unavailable, ineffective, or financially prohibitive. Further investigation is warranted to establish optimal dosing protocols and long-term efficacy.

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