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The Lead Episode 25: A Discussion of Feasibility and Safety of Intravenous Sotalol Loading in Adult Patients With Atrial Fibrillation (DASH-AF)
A total of 120 patients from 3 centers were enrolled from 2021 to 2022 in the IV loading group (compared with type of AF– and renal function–matched patients in the conventional PO loading cohort). This study demonstrated no significant change in ΔQTc in both groups, with a significantly lower number of patients requiring dose adjustment in the IV arm compared with the PO arm (4.1% vs 16.6%; P = 0.003). This led to potential cost savings of up to $3,500.68 per admission. The DASH-AF trial shows that rapid IV sotalol loading in atrial fibrillation/flutter patients for rhythm control is feasible and safe compared with conventional oral loading with significant cost reduction. (Feasibility and Safety of Intravenous Sotalol Administered as a Loading Dose to Initiate Oral Sotalol Therapy in Adult Patients With Atrial Fibrillation [DASH-AF]; NCT04473807)
Learning Objectives
  • Evaluate the safety and feasibility of rapid IV sotalol loading compared to conventional oral loading for rhythm control in patients with atrial arrhythmias, with a focus on assessing changes in QTc intervals and the need for dose adjustments.
  • To analyze the cost-effectiveness of the IV loading approach in atrial arrhythmia treatment by quantifying potential cost savings, including those associated with hospitalization and healthcare resource utilization.
  • To explore the potential implications of the DASH-AF study's findings on clinical practice and healthcare policies, with an emphasis on the shift from conventional 3-day PO loading to 1-day IV sotalol loading and the safety considerations during patient discharge.
Article Authors and Podcast Contributors
Article Authors
Dhanunjaya Lakkireddy, Adnan Ahmed, Donita Atkins, Danish Bawa, Jalaj Garg, Jenny Bush, Rishi Charate, Sudha Bommana, Naga Venkata K. Pothineni, Rajesh Kabra, Douglas Darden, Scott Koreber, Rangarao Tummala, Chandrashekar Vasamreddy, Peter Park, Sanghamitra Mohanty, Rakesh Gopinathannair, B. Woun Seo, Andrea Natale, and Robert Kennedy

Podcast Contributors
Deepthy Varghese, MSN, ACNP, FNP, of Northside Hospital

Alok Gambhir, MD, DPhil, FHRS, of Northside Hospital
Megan LaBreck, PharmD, BCPD, CACP, of Riverside Methodist Hospital

Disclosure Policy

ACE Disclosure Policy

The Heart Rhythm Society is committed to the provision of Accredited Continuing Education (formerly known as Continuing Medical Education (CME)) that is balanced, objective, and evidence based. HRS adheres to the Standards for Integrity and Independence in Accredited Continuing Education of the Accreditation Council for Continuing Medical Education (ACCME) which require that those individuals in a position to control the content of an educational activity (including, but not limited to, planners, faculty, authors, committee members, content reviewers, editors, and staff) disclose all financial relationships with an ACCME-defined ineligible company* within the 24 months prior to the disclosure.


Any individual who refuses to disclose financial relationships is disqualified from participating in HRS ACE-certified activities. Owners and employees of ACCME-defined ineligible companies may have no role in the planning or implementation of ACE activities without a special written exemption from the HRS Chief Learning Officer that will be granted only in specific circumstances that meet ACCME requirements.

ACCME Definition:

*An ineligible company is one whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Examples of such organizations include:

  • Advertising, marketing, or communication firms whose clients are ineligible companies
  • Bio-medical startups that have begun a governmental regulatory approval process
  • Compounding pharmacies that manufacture proprietary compounds
  • Device manufacturers or distributors
  • Diagnostic labs that sell proprietary products
  • Growers, distributors, manufacturers or sellers of medical foods and dietary supplements
  • Manufacturers of health-related wearable products
  • Pharmaceutical companies or distributors
  • Pharmacy benefit managers
  • Reagent manufacturers or sellers


All relevant financial relationships have been mitigated.

Host Disclosure(s):
D. Varghese: No relevant financial relationships with ineligible companies to disclose. 

Contributor Disclosure(s):

A. Gambhir: Honoraria/Speaking/Consulting Fee: Boston Scientific, Abbott Medical, Biosense Webster, Zywie
M. LaBreck: Honoraria/Speaking/Consulting Fee: Boston Scientific

Staff Disclosure(s) (note: HRS staff are NOT in control of educational content. Disclosures are provided solely for full transparency to the learner):
J. Glenn: No relevant financial relationships with ineligible companies to disclose. 
S. Sailor: No relevant financial relationships with ineligible companies to disclose.
Availability: On-Demand
Cost: FREE
Credit Offered:
No Credit Offered
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