Which medication used to treat atrial fibrillation is associated with the risk of torsades de pointes?

Sotalol is indeed associated with the risk of torsades de pointes, which is a form of polymorphic ventricular tachycardia. Sotalol is a Class III antiarrhythmic that works by blocking potassium channels, particularly the rapid component of the delayed rectifier potassium current. This action prolongs the QT interval, which can lead to an increased risk of life-threatening arrhythmias, particularly in the presence of other factors such as electrolyte imbalances or concurrent use of other medications that prolong the QT interval.

Monitoring the QT interval is critical when administering sotalol, especially at higher doses or in patients with a history of cardiac issues. The risk of torsades de pointes can be exacerbated by factors such as renal impairment or significant heart failure, both of which can affect drug clearance and increase drug accumulation.

In contrast, while medications like amiodarone, dronedarone, and digoxin have their own risk profiles and side effects, they do not share the same level of association with torsades de pointes as sotalol does. Amiodarone has a different mechanism of action and is less likely to cause significant QT prolongation, dronedarone was developed to reduce the proarrhyth