Evidence map›Paper›PMID 31539628›Full record

ArticleHeart rhythm2020

Changes in global electrical heterogeneity associated with dofetilide, quinidine, ranolazine, and verapamil.

Hans Friedrich Stabenau, Changyu Shen, Larisa G Tereshchenko, Jonathan W Waks

Open access · greenAbstract read
In one paragraph

Article in Heart rhythm, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Hans Friedrich StabenauDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Changyu ShenSmith Center for Outcomes Research in Cardiology Beth Israel Deaconess Medical Center Harvard Medical School, Boston, Massachusetts.
Larisa G TereshchenkoKnight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon.
Jonathan W WaksHarvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts. Electronic address: jwaks@bidmc.harvard.edu.
Beth Israel Deaconess Medical Center · USBrigham and Women's Hospital · USOregon Health & Science University · US

Funding

Novel ECG Measures and Risk of Sudden Cardiac DeathR01HL118277 · NHLBI · OREGON HEALTH & SCIENCE UNIVERSITY · PI TERESHCHENKO, LARISA GENNADIEVNA · 2013 to 2016
$1.5M
Novel ECG measures and risk of sudden cardiac deathR56HL118277 · NHLBI · OREGON HEALTH & SCIENCE UNIVERSITY · PI TERESHCHENKO, LARISA GENNADIEVNA · 2018 to 2018
$396k
NHLBI NIH HHS R01 HL118277NHLBI NIH HHS R56 HL118277
6 · The paper itself

Abstract

backgroundElectrocardiographic (ECG) markers of antiarrhythmic drug (AAD) activity could be used to optimize efficacy and minimize toxicity. Vectorcardiographic global electrical heterogeneity (GEH) is associated with ventricular arrhythmias and sudden death, but it is unclear how GEH measurements change in response to AADs.

objectiveThe purpose of this study was to characterize acute effects of AADs on GEH measurements.

methodsWe analyzed double-blind placebo-controlled trial data from healthy volunteers given 1 dose of placebo, dofetilide, quinidine, ranolazine, or verapamil on subsequent visits. Serial ECGs and plasma drug concentrations were collected. Vectorcardiographic GEH parameters (spatial ventricular gradient [SVG], spatial QRST angle, sum absolute QRST integral, and SVG-QRS peak angle) were measured. Placebo-corrected change from baseline was regressed on drug concentration stratified by sex using linear mixed effects models.

resultsAmong 22 persons (11 (50%) male median age 27 ± 5 years), 5232 ECGs were analyzed. Dofetilide and quinidine were associated with significant changes in more GEH parameters (5) compared with verapamil (2) and ranolazine (1). The most notable change occurred in SVG azimuth, with largest changes (degrees per unit normalized drug concentration) in dofetilide (6.1; 95% confidence interval [CI] 4.2-8.0) and quinidine (9.4; 95% CI 6.7-12.0), and smaller effects in verapamil (4.4; 95% CI 2.9-5.9) and ranolazine (5.4; 95% CI 3.5-7.3). AAD-induced GEH changes significantly differed in men and women.

conclusionAADs change GEH measurements. These changes, which differ by sex, are likely driven by alterations in ion channel function and dispersion of depolarization or repolarization. GEH measurement may allow early assessment of favorable or adverse AAD effects.

Indexed as

AdultAnti-Arrhythmia AgentsArrhythmias, CardiacCross-Over StudiesDose-Response Relationship, DrugDouble-Blind MethodDrug Therapy, CombinationElectrocardiographyFemaleHeart VentriclesHumansMalePhenethylaminesPotassium Channel BlockersQuinidineRanolazineAnti-Arrhythmia AgentsdofetilidePhenethylaminesPotassium Channel BlockersQuinidineRanolazineSodium Channel BlockersSulfonamidesAntiarrhythmic drugsElectrical heterogeneityVectorcardiography

Identifiers

PMID31539628
PMCPMC7056537
OpenAlexW2973401468

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.