Can sotalol initiation for atrial fibrillation be performed safely outpatient, and if so, what would be a reasonable protocol for implementing this? 

In my opinion, sotalol (and Tikosyn) should never be initiated as an outpatient. We have all seen cases of torsades at some point in our careers related to sotalol initiation and QT prolongation, even when resuming a dose that was previously tolerated. There is a nice review article published in JACC in 1998 by Mina Chung and colleagues from Cleveland Clinic showing that clinically significant arrhythmia related complications can be detected with in hospital monitoring in one of five patients starting sotalol. The only time I have done sotalol as an outpatient was in someone who had an ICD, was previously on sotalol and I was restarting at a lower dose than previously tolerated. Even in this setting, I had the patient obtain an EKG on day 3...