**Question:** What is the drug of choice to control supraventricular tachycardia:

A. Amiodarone
B. Beta-blockers (e.g., Metoprolol)
C. Sotalol
D. Digoxin

**Correct Answer:** C. Sotalol

**Core Concept:**
Supraventricular tachycardia (SVT) is a type of rapid heart rate that originates from the heart's upper chambers (atria) or the atrioventricular node. Treatment for SVT aims to restore sinus rhythm, which is the normal heart rhythm.

**Why the Correct Answer is Right:**
Sotalol is a beta-blocker and class III antiarrhythmic agent. Its mechanism of action involves blocking beta-1 receptors, thereby reducing heart rate and contractility. Additionally, sotalol has class III properties that prolong the action potential, which helps in suppressing arrhythmias like SVT. In comparison to other options, sotalol is the most effective drug for controlling SVT.

**Why Each Wrong Option is Incorrect:**

A. Amiodarone: Although amiodarone can be used for various arrhythmias, it is not the drug of choice for SVT. It has broader antiarrhythmic properties and is more effective in treating complex arrhythmias like atrial fibrillation.

B. Beta-blockers like metoprolol are generally used for controlling ventricular arrhythmias like supraventricular premature contractions, but they are less effective in treating SVT. Beta-blockers are mainly used to reduce heart rate, while class III antiarrhythmic agents like sotalol are more effective in controlling SVT.

D. Digoxin is primarily used for heart failure management, digoxin toxicity, or atrial fibrillation, not specifically for SVT. It is less effective than sotalol and other class III antiarrhythmic agents in controlling SVT.

**Clinical Pearl:**
Sotalol is a valuable drug for the treatment of SVT, particularly when rapid ventricular response is present. Its dual action on beta-1 receptors and class III properties makes it a more effective choice compared to other options for controlling SVT.