Proarrhythmic effects of antiarrhythmic drugs

Douglas P. Zipes

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

Antiarrhythmic agents can worsen existing arrhythmias by increasing their duration or frequency, increasing the number of premature complexes or couplets, altering the rate of the arrhythmia or causing new, previously unexperienced arrhythmias. QT prolongation occurs in many settings, not all of which are associated with increased arrhythmia development. Arrhythmogenesis in the setting of a long QT interval may be related to marked asynchrony of repolarization. The role of afterdepolarizations is still being investigated. No correlation has been established between the occurrence of torsades de pointes, a specific degree of QT prolongation and either the dose or serum concentration of any of the antiarrhythmic agents. In 30 patients who experienced drug-induced ventricular fibrillation, the median time to ventricular fibrillation was only 3 days after drug treatment began. Significant caution must be exercised in determining the need for antiarrhythmic therapy and in monitoring patients after treatment has begun.

Original languageEnglish
JournalThe American Journal of Cardiology
Volume59
Issue number11
DOIs
StatePublished - Apr 30 1987

Fingerprint

Anti-Arrhythmia Agents
Cardiac Arrhythmias
Ventricular Fibrillation
Torsades de Pointes
Physiologic Monitoring
Pharmaceutical Preparations
Therapeutics
Serum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Proarrhythmic effects of antiarrhythmic drugs. / Zipes, Douglas P.

In: The American Journal of Cardiology, Vol. 59, No. 11, 30.04.1987.

Research output: Contribution to journalArticle

@article{7cd3bb89b06648b98503b581ae930e50,
title = "Proarrhythmic effects of antiarrhythmic drugs",
abstract = "Antiarrhythmic agents can worsen existing arrhythmias by increasing their duration or frequency, increasing the number of premature complexes or couplets, altering the rate of the arrhythmia or causing new, previously unexperienced arrhythmias. QT prolongation occurs in many settings, not all of which are associated with increased arrhythmia development. Arrhythmogenesis in the setting of a long QT interval may be related to marked asynchrony of repolarization. The role of afterdepolarizations is still being investigated. No correlation has been established between the occurrence of torsades de pointes, a specific degree of QT prolongation and either the dose or serum concentration of any of the antiarrhythmic agents. In 30 patients who experienced drug-induced ventricular fibrillation, the median time to ventricular fibrillation was only 3 days after drug treatment began. Significant caution must be exercised in determining the need for antiarrhythmic therapy and in monitoring patients after treatment has begun.",
author = "Zipes, {Douglas P.}",
year = "1987",
month = "4",
day = "30",
doi = "10.1016/0002-9149(87)90198-6",
language = "English",
volume = "59",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "11",

}

TY - JOUR

T1 - Proarrhythmic effects of antiarrhythmic drugs

AU - Zipes, Douglas P.

PY - 1987/4/30

Y1 - 1987/4/30

N2 - Antiarrhythmic agents can worsen existing arrhythmias by increasing their duration or frequency, increasing the number of premature complexes or couplets, altering the rate of the arrhythmia or causing new, previously unexperienced arrhythmias. QT prolongation occurs in many settings, not all of which are associated with increased arrhythmia development. Arrhythmogenesis in the setting of a long QT interval may be related to marked asynchrony of repolarization. The role of afterdepolarizations is still being investigated. No correlation has been established between the occurrence of torsades de pointes, a specific degree of QT prolongation and either the dose or serum concentration of any of the antiarrhythmic agents. In 30 patients who experienced drug-induced ventricular fibrillation, the median time to ventricular fibrillation was only 3 days after drug treatment began. Significant caution must be exercised in determining the need for antiarrhythmic therapy and in monitoring patients after treatment has begun.

AB - Antiarrhythmic agents can worsen existing arrhythmias by increasing their duration or frequency, increasing the number of premature complexes or couplets, altering the rate of the arrhythmia or causing new, previously unexperienced arrhythmias. QT prolongation occurs in many settings, not all of which are associated with increased arrhythmia development. Arrhythmogenesis in the setting of a long QT interval may be related to marked asynchrony of repolarization. The role of afterdepolarizations is still being investigated. No correlation has been established between the occurrence of torsades de pointes, a specific degree of QT prolongation and either the dose or serum concentration of any of the antiarrhythmic agents. In 30 patients who experienced drug-induced ventricular fibrillation, the median time to ventricular fibrillation was only 3 days after drug treatment began. Significant caution must be exercised in determining the need for antiarrhythmic therapy and in monitoring patients after treatment has begun.

UR - http://www.scopus.com/inward/record.url?scp=0023177795&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023177795&partnerID=8YFLogxK

U2 - 10.1016/0002-9149(87)90198-6

DO - 10.1016/0002-9149(87)90198-6

M3 - Article

C2 - 2437787

AN - SCOPUS:0023177795

VL - 59

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 11

ER -