{"id":"https://openalex.org/W1978481774","doi":"https://doi.org/10.1002/ddr.430190206","title":"Clinical features of arrhythmia aggravation by antiarrhythmic drugs and their implications for basic mechanisms","display_name":"Clinical features of arrhythmia aggravation by antiarrhythmic drugs and their implications for basic mechanisms","publication_year":1990,"publication_date":"1990-01-01","ids":{"openalex":"https://openalex.org/W1978481774","doi":"https://doi.org/10.1002/ddr.430190206","mag":"1978481774"},"language":"en","primary_location":{"id":"doi:10.1002/ddr.430190206","doi":"https://doi.org/10.1002/ddr.430190206","is_oa":false,"landing_page_url":"https://doi.org/10.1002/ddr.430190206","pdf_url":null,"source":{"id":"https://openalex.org/S26306840","display_name":"Drug Development Research","issn_l":"0272-4391","issn":["0272-4391","1098-2299"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Drug Development Research","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5058141203","display_name":"Dan M. Roden","orcid":"https://orcid.org/0000-0002-6302-0389","observed_orcids":["https://orcid.org/0000-0002-6302-0389"]},"institutions":[{"id":"https://openalex.org/I200719446","display_name":"Vanderbilt University","ror":"https://ror.org/02vm5rt34","country_code":"US","type":"education","lineage":["https://openalex.org/I200719446"]},{"id":"https://openalex.org/I901861585","display_name":"Vanderbilt University Medical Center","ror":"https://ror.org/05dq2gs74","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I4210162197","https://openalex.org/I901861585"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Dan M. Roden","raw_affiliation_strings":["Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee","institution_ids":["https://openalex.org/I200719446","https://openalex.org/I901861585"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5058141203"],"corresponding_institution_ids":["https://openalex.org/I200719446","https://openalex.org/I901861585"],"apc_list":{"value":3980,"currency":"USD","value_usd":3980},"apc_paid":null,"fwci":0.7655,"has_fulltext":false,"cited_by_count":12,"citation_normalized_percentile":{"value":0.70800106,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":93},"biblio":{"volume":"19","issue":"2","first_page":"153","last_page":"172"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10217","display_name":"Cardiac electrophysiology and arrhythmias","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10217","display_name":"Cardiac electrophysiology and arrhythmias","score":0.9955999851226807,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11217","display_name":"Cardiac Arrhythmias and Treatments","score":0.003599999938160181,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10598","display_name":"Cardiac pacing and defibrillation studies","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/antiarrhythmic-drugs","display_name":"antiarrhythmic drugs","score":0.8769999742507935},{"id":"https://openalex.org/keywords/drug-induced-arrhythmia","display_name":"drug-induced arrhythmia","score":0.8899999856948853},{"id":"https://openalex.org/keywords/torsades-de-pointes","display_name":"torsades de pointes","score":0.8989999890327454},{"id":"https://openalex.org/keywords/ventricular-tachycardia","display_name":"ventricular tachycardia","score":0.8209999799728394},{"id":"https://openalex.org/keywords/microreentry","display_name":"microreentry","score":0.7879999876022339},{"id":"https://openalex.org/keywords/early-afterdepolarizations","display_name":"early afterdepolarizations","score":0.8460000157356262},{"id":"https://openalex.org/keywords/adverse-drug-reactions","display_name":"adverse drug reactions","score":0.6389999985694885},{"id":"https://openalex.org/keywords/quinidine","display_name":"quinidine","score":0.7120000123977661},{"id":"https://openalex.org/keywords/sotalol","display_name":"sotalol","score":0.972000002861023}],"concepts":[{"id":"https://openalex.org/C2780486423","wikidata":"https://www.wikidata.org/wiki/Q1625433","display_name":"Torsades de pointes","level":3,"score":0.8210722804069519},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7841825485229492},{"id":"https://openalex.org/C2779837460","wikidata":"https://www.wikidata.org/wiki/Q421381","display_name":"Flecainide","level":3,"score":0.7756528854370117},{"id":"https://openalex.org/C2776639339","wikidata":"https://www.wikidata.org/wiki/Q413591","display_name":"Sotalol","level":3,"score":0.7531267404556274},{"id":"https://openalex.org/C155730078","wikidata":"https://www.wikidata.org/wiki/Q2898697","display_name":"Afterdepolarization","level":4,"score":0.6708483695983887},{"id":"https://openalex.org/C2777028498","wikidata":"https://www.wikidata.org/wiki/Q417597","display_name":"Procainamide","level":2,"score":0.6575523614883423},{"id":"https://openalex.org/C2776331378","wikidata":"https://www.wikidata.org/wiki/Q56002","display_name":"Ventricular tachycardia","level":2,"score":0.5773040652275085},{"id":"https://openalex.org/C2778292772","wikidata":"https://www.wikidata.org/wiki/Q1506572","display_name":"Atrial flutter","level":3,"score":0.5737441778182983},{"id":"https://openalex.org/C2780339425","wikidata":"https://www.wikidata.org/wiki/Q412496","display_name":"Quinidine","level":2,"score":0.5699824094772339},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.5535227060317993},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5255333781242371},{"id":"https://openalex.org/C2781472538","wikidata":"https://www.wikidata.org/wiki/Q662511","display_name":"Propafenone","level":3,"score":0.4937795102596283},{"id":"https://openalex.org/C2778094803","wikidata":"https://www.wikidata.org/wiki/Q410061","display_name":"Amiodarone","level":3,"score":0.4815954864025116},{"id":"https://openalex.org/C2777796741","wikidata":"https://www.wikidata.org/wiki/Q3712521","display_name":"Dofetilide","level":3,"score":0.43910977244377136},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.41315779089927673},{"id":"https://openalex.org/C2778242168","wikidata":"https://www.wikidata.org/wiki/Q794086","display_name":"Hypokalemia","level":2,"score":0.41145703196525574},{"id":"https://openalex.org/C118441451","wikidata":"https://www.wikidata.org/wiki/Q12074763","display_name":"QT interval","level":2,"score":0.3266419768333435},{"id":"https://openalex.org/C146403970","wikidata":"https://www.wikidata.org/wiki/Q205729","display_name":"Repolarization","level":3,"score":0.26891687512397766},{"id":"https://openalex.org/C2779161974","wikidata":"https://www.wikidata.org/wiki/Q815819","display_name":"Atrial fibrillation","level":2,"score":0.16896283626556396},{"id":"https://openalex.org/C185263204","wikidata":"https://www.wikidata.org/wiki/Q1154774","display_name":"Electrophysiology","level":2,"score":0.12068331241607666},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1002/ddr.430190206","doi":"https://doi.org/10.1002/ddr.430190206","is_oa":false,"landing_page_url":"https://doi.org/10.1002/ddr.430190206","pdf_url":null,"source":{"id":"https://openalex.org/S26306840","display_name":"Drug Development Research","issn_l":"0272-4391","issn":["0272-4391","1098-2299"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-c","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-70","russia-white-list-1"],"host_organization":"https://openalex.org/P4310320595","host_organization_name":"Wiley","host_organization_lineage":["https://openalex.org/P4310320595"],"host_organization_lineage_names":["Wiley"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Drug Development Research","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":101,"referenced_works":["https://openalex.org/W574413806","https://openalex.org/W1534683015","https://openalex.org/W1698716359","https://openalex.org/W1963866558","https://openalex.org/W1970915231","https://openalex.org/W1972623266","https://openalex.org/W1973480228","https://openalex.org/W1974851666","https://openalex.org/W1975629438","https://openalex.org/W1977109174","https://openalex.org/W1978565574","https://openalex.org/W1979259734","https://openalex.org/W1981098216","https://openalex.org/W1981144345","https://openalex.org/W1986457340","https://openalex.org/W1990183559","https://openalex.org/W1991120591","https://openalex.org/W1994957766","https://openalex.org/W1999756294","https://openalex.org/W2000234314","https://openalex.org/W2000237138","https://openalex.org/W2005411701","https://openalex.org/W2005604952","https://openalex.org/W2005631766","https://openalex.org/W2007291201","https://openalex.org/W2008485605","https://openalex.org/W2011476261","https://openalex.org/W2012829301","https://openalex.org/W2014562798","https://openalex.org/W2015169899","https://openalex.org/W2016514490","https://openalex.org/W2018310545","https://openalex.org/W2018328437","https://openalex.org/W2021496436","https://openalex.org/W2026508775","https://openalex.org/W2027829749","https://openalex.org/W2028582328","https://openalex.org/W2033740818","https://openalex.org/W2035105123","https://openalex.org/W2035836568","https://openalex.org/W2035882092","https://openalex.org/W2036090746","https://openalex.org/W2037244852","https://openalex.org/W2038468372","https://openalex.org/W2038773418","https://openalex.org/W2041800048","https://openalex.org/W2042393423","https://openalex.org/W2044792121","https://openalex.org/W2047180798","https://openalex.org/W2050456702","https://openalex.org/W2060360193","https://openalex.org/W2060924724","https://openalex.org/W2061967268","https://openalex.org/W2062851203","https://openalex.org/W2063406626","https://openalex.org/W2063497613","https://openalex.org/W2064543031","https://openalex.org/W2069116111","https://openalex.org/W2071411262","https://openalex.org/W2071412839","https://openalex.org/W2079647007","https://openalex.org/W2081517567","https://openalex.org/W2083397218","https://openalex.org/W2084431360","https://openalex.org/W2085773239","https://openalex.org/W2087514001","https://openalex.org/W2087631949","https://openalex.org/W2093598697","https://openalex.org/W2094892482","https://openalex.org/W2100069431","https://openalex.org/W2102259200","https://openalex.org/W2110061674","https://openalex.org/W2113205108","https://openalex.org/W2113745107","https://openalex.org/W2113759120","https://openalex.org/W2135114508","https://openalex.org/W2156398676","https://openalex.org/W2161780178","https://openalex.org/W2165135845","https://openalex.org/W2165354490","https://openalex.org/W2168818115","https://openalex.org/W2172086894","https://openalex.org/W2184156660","https://openalex.org/W2259349819","https://openalex.org/W2262764147","https://openalex.org/W2298540358","https://openalex.org/W2319931350","https://openalex.org/W2323345863","https://openalex.org/W2325116796","https://openalex.org/W2327467387","https://openalex.org/W2342098126","https://openalex.org/W2342455355","https://openalex.org/W2397612742","https://openalex.org/W2398189163","https://openalex.org/W2398573488","https://openalex.org/W2413301333","https://openalex.org/W2413511928","https://openalex.org/W2434525696","https://openalex.org/W2471446929","https://openalex.org/W2474746677","https://openalex.org/W4234672201"],"related_works":["https://openalex.org/W1898218935","https://openalex.org/W2053089245","https://openalex.org/W3145365308","https://openalex.org/W2034573541","https://openalex.org/W1966539606","https://openalex.org/W7097589336","https://openalex.org/W2031368788","https://openalex.org/W2093784373","https://openalex.org/W1775848859","https://openalex.org/W1989632618"],"abstract_inverted_index":{"Abstract":[0],"Although":[1,269],"cardiac":[2,83],"arrhythmias":[3,84],"are":[4,53,59,135,153,207,307],"major":[5,24,104],"cause":[6],"of":[7,13,40,63,71,107,117,130,150,158,166,175,181,198,240,264,275,330,364,368,395],"morbidity":[8],"and":[9,102,133,205,325,374,410],"mortality,":[10],"widespread":[11],"use":[12],"antiarrhythmic":[14,32,66,170,372,412],"drugs":[15,33,171,242,373],"is":[16,28,74,172,223,259,271],"not":[17,308,383],"appropriate":[18,245,348],"at":[19,353],"this":[20,220,256,270],"time":[21],"for":[22,155,190,215,356,407],"two":[23],"reasons:":[25],"(1)":[26],"There":[27],"no":[29],"evidence":[30],"that":[31,144,231],"alter":[34],"mortality":[35],"in":[36,127,147,179,186,219,298,377,385,391,404],"the":[37,103,115,148,156,173,199,212,236,241,260,276,365,378,396],"vast":[38],"majority":[39],"patients;":[41],"further":[42],"data":[43],"will":[44],"be":[45,226,352],"forthcoming":[46],"from":[47,149],"large\u2010scale":[48],"multicentered":[49],"clinical":[50,90,138,257,366],"trials":[51],"which":[52],"currently":[54],"underway.":[55],"(2)":[56],"Side":[57],"effect":[58],"a":[60,118,176,296,337,340],"prominent":[61],"feature":[62],"therapy":[64],"with":[65,96,114,194,273,295,332],"drugs.":[67],"The":[68,162],"most":[69,208],"striking":[70],"these":[72,86,350],"toxicities":[73],"apparently":[75],"paradoxical":[76],"provocation":[77],"of,":[78,82],"rather":[79,248],"than":[80,249],"suppression":[81],"by":[85,169,371],"agents.":[87],"Two":[88],"common":[89,164],"entities":[91],"have":[92,284,343,381],"been":[93,112,286,344],"recognized.":[94],"Therapy":[95,193],"action\u2010potential\u2010prolonging":[97],"agents,":[98],"including":[99,203],"quinidine,":[100],"sotalol,":[101],"active":[105],"metabolite":[106],"procainamide,":[108,110],"N\u2010acetyl":[109],"has":[111],"associated":[113,137,294],"development":[116,174],"morphologically":[119],"distinctive":[120],"polymorphic":[121],"ventricular":[122,183,191,217,267],"tachycardia,":[123],"Torsades":[124,159],"de":[125,160],"Points,":[126],"approximately":[128],"5%":[129],"patients.":[131],"Bradycardia":[132],"hypokalemia":[134],"commonly":[136,209],"features.":[139],"In":[140],"vitro":[141],"studies":[142],"indicate":[143],"triggered":[145],"automaticity,":[146],"early":[151],"afterdepolarizations,":[152],"responsible":[154],"genesis":[157],"Pointes.":[161],"second":[163],"form":[165],"arrhythmia":[167,369],"aggravation":[168,370],"marked":[177],"increase":[178],"frequency":[180],"sustained":[182,216],"tachycardia":[184,218],"events":[185],"patients":[187,331],"being":[188],"treated":[189],"tachycardia.":[192],"sodium":[195,281],"channel":[196,282],"blockers":[197,283],"\u201cclass":[200,237,277],"Ic\u201d":[201,238,278],"subtype,":[202,279],"flecainide":[204],"encainide,":[206],"implicated.":[210],"Since":[211],"underlying":[213,326],"mechanism":[214],"patient":[221,387],"population":[222],"thought":[224],"to":[225,235,311],"microreentry,":[227],"it":[228],"appears":[229,293],"likely":[230],"slow":[232],"conduction":[233],"due":[234],"properties":[239],"may":[243,351,402],"under":[244,347],"conditions":[246],"enable":[247],"block":[250],"reentrant":[251],"circuits.":[252],"A":[253],"variation":[254],"on":[255,336,339],"entity":[258],"increasingly":[261],"recognized":[262],"phenomenon":[263],"drug\u2010induced":[265],"impaired":[266],"defibrillation.":[268],"recognised":[272],"agents":[274],"other":[280],"also":[285,390],"implicated,":[287],"while":[288],"action":[289,306],"potential":[290],"prologation":[291],"actually":[292],"decrease":[297],"defibrillation":[299],"energy":[300],"requirements.":[301],"These":[302],"adverse":[303,357],"electrophysiologic":[304,358],"drug":[305,321,334,359],"tightly":[309],"linked":[310],"high":[312],"plasma":[313,323],"concentrations;":[314],"rather,":[315],"they":[316],"represent":[317],"an":[318,392],"interplay":[319],"among":[320],"dose,":[322],"concentration,":[324],"substrate.":[327],"However,":[328],"subsets":[329],"variant":[333],"metabolism":[335],"genetic":[338,341],"basis":[342],"identified":[345],"and,":[346,400],"circumstances,":[349],"increased":[354,393],"risk":[355],"actions.":[360],"Thus,":[361],"intensive":[362],"study":[363],"features":[367],"their":[375],"correlates":[376],"basic":[379],"laboratory":[380],"resulted":[382],"only":[384],"improved":[386,405],"care":[388],"but":[389],"understanding":[394],"fundamental":[397],"mechanisms":[398],"responsible,":[399],"potentially,":[401],"result":[403],"method":[406],"identifying":[408],"new":[409],"safer":[411],"compounds.":[413]},"counts_by_year":[{"year":2013,"cited_by_count":1}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2016-06-24T00:00:00"}