{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T23:44:21Z","timestamp":1773791061882,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T00:00:00Z","timestamp":1641340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There exists variability in the administration of in\u2010patient sotalol therapy for symptomatic atrial fibrillation (AF). The impact of this variability on patient in\u2010hospital and 30\u2010day posthospitalization costs and outcomes is not known. Also, the cost impact of intravenous sotalol, which can accelerate drug loading to therapeutic levels, is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and thirty\u2010three AF patients admitted for oral sotalol initiation at an Intermountain Healthcare Hospital from January 2017 to December 2018 were included. Patient and dosing characteristics were described descriptively\u00a0and the impact of dosing schedule was correlated with daily hospital costs\/clinical outcomes during the index hospitalization and for 30 days. The Centers for Medicare and Medicaid Services reimbursement for 3\u2010day sotalol initiation is $9263.51. Projections of cost savings were made considering a 1\u2010day load using intravenous sotalol that costs $2500.00 to administer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The average age was 70.3\u2009\u00b1\u200912.3 years\u00a0and 60.2% were male with comorbidities of\u00a0hypertension (83%), diabetes (36%), and coronary artery disease (53%). The mean ejection fraction was 59.9\u2009\u00b1\u20097.8% and the median corrected QT interval\u00a0was 453.7\u2009\u00b1\u200937.6\u2009ms before sotalol dosing. No ventricular arrhythmias developed, but bradycardia (&lt;60\u2009bpm) was observed in 37.6% of patients. The average length of stay was 3.9\u2009\u00b1\u20094.6 (median: 2.2) days. Postdischarge outcomes and rehospitalization rates stratified by length of stay were similar. The cost per day was estimated at $2931.55 (1. $2931.55, 2. $5863.10, 3. $8794.65, 4. $11\u2009726.20).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In\u2010patient oral sotalol dosing is markedly variable and results in the potential of both cost gain and loss to a hospital. In consideration of estimated costs, there is the potential for $871.55 cost savings compared to a 2\u2010day oral load and $3803.10 compared to a 3\u2010day oral load.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15342","type":"journal-article","created":{"date-parts":[[2021,12,25]],"date-time":"2021-12-25T10:44:35Z","timestamp":1640429075000},"page":"333-342","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Economics and outcomes of sotalol in\u2010patient dosing approaches in patients with atrial fibrillation"],"prefix":"10.1111","volume":"33","author":[{"given":"Daniel L.","family":"Varela","sequence":"first","affiliation":[{"name":"Cardiology Division University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyson S.","family":"Burnham","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"T. May","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tami","family":"L. Bair","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4729-7820","authenticated-orcid":false,"given":"Benjamin A.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"B. Muhlestein","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-8685","authenticated-orcid":false,"given":"Jeffrey","family":"L. Anderson","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirk","family":"U. Knowlton","sequence":"additional","affiliation":[{"name":"Intermountain Medical Center Heart Institute  Murray Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5349-0136","authenticated-orcid":false,"given":"Thomas","family":"Jared Bunch","sequence":"additional","affiliation":[{"name":"Cardiology Division University of Utah School of Medicine  Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,1,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2015.07.002"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.958165"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009024"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1L698"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrcr.2019.04.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/1074248419887710"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2018.03.017"},{"key":"e_1_2_9_9_1","unstructured":"United States Food and Drug Administration and ALTATHERA Pharmaceuticals L. C. Sotalol hydrochloride FDA label: highlights of prescribing information.\u00a0Accessed November 2 2020.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/\/022306s005lblrpl.pdf"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2019.04.457"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/cts.12670"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.14740\/cr1143"},{"key":"e_1_2_9_13_1","unstructured":"US FDA. \u00a0US Food and Drug Administration (FDA) clinical pharmacology review\u2014Betapace. 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