Abstract:
:Flecainide acetate has a recognized proarrhythmic effect in patients treated for ventricular tachycardia. Three patients developed severe ventricular arrhythmias while taking flecainide for atrial fibrillation. Patient 1 had normal ventricular function and idiopathic atrial fibrillation. Treadmill exercise tests during digoxin therapy showed no ventricular arrhythmia; however, during flecainide therapy the patient developed ventricular flutter at his peak exercise level that required cardioversion. Patient 2 had normal ventricular function and a prosthetic mitral valve. During therapy with flecainide, 150 mg twice daily, he had an episode of sustained ventricular tachycardia, also at his peak exercise level. Patient 3 had paroxysmal atrial fibrillation and hypertrophic cardiomyopathy but no previous ventricular arrhythmia. She died suddenly within 10 days of starting flecainide therapy. Judged from previous findings none of these patients was considered at high risk for proarrhythmia. These cases suggest a possible relation between vigorous exercise, atrial fibrillation, and the proarrhythmic properties of flecainide and indicate the limitations of classifying patients as "high-risk" or "low-risk" for proarrhythmic complications of anti-arrhythmic therapy.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Falk RHdoi
10.7326/0003-4819-111-2-107subject
Has Abstractpub_date
1989-07-15 00:00:00pages
107-11issue
2eissn
0003-4819issn
1539-3704journal_volume
111pub_type
杂志文章abstract::A retrospective analysis of the course of systemic lupus erythematosus in pregnant patients hospitalized at UCLA during a 15-year period provided important prognostic information. Women with systemic lupus erythematosus became pregnant if renal function was reasonably well preserved. Pregnancy infrequently posed a ser...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-5-667
更新日期:1981-05-01 00:00:00
abstract::A patient with bladder carcinoma metastatic to lung and brain died of pneumonia. Autopsy examination showed a confluent bronchopneumonia with several small abscesses and acute pyelonephritis with abscess formation. Legionella pneumophila, serogroup 4, was isolated in pure culture from lung tissue postmortem and was al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-93-6-835
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) are anti-inflammatory but have been linked in some studies to Crohn disease (CD) and ulcerative colitis (UC). OBJECTIVE:To assess the association between aspirin and NSAID use and incident CD and UC. DESIGN:Prospective cohort study. SETTING:Nurses'...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-156-5-201203060-00007
更新日期:2012-03-06 00:00:00
abstract:STUDY OBJECTIVE:To define the clinical and hematologic effects of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) on patients with chronic severe neutropenia. DESIGN:Open-label, phase II study of rhGM-CSF. SETTING:Inpatient hematology and surgery clinic at a university medical center. P...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-11-887
更新日期:1989-12-01 00:00:00
abstract:BACKGROUND:Successful outcomes after cardiopulmonary resuscitation remain disappointingly infrequent, in animal studies, administration of exogenous vasopressin during closed- and open-chest cardiopulmonary resuscitation has recently been shown to be more effective than optimal doses of epinephrine in improving vital o...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-124-12-199606150-00006
更新日期:1996-06-15 00:00:00
abstract:OBJECTIVE:To determine whether diabetic patients, when compared with nondiabetic patients, have a higher incidence of restenosis after coronary stenting, and, if so, whether restenosis is attributable to lesion or procedural differences or to a greater biologic tendency for late loss of minimum diameter in diabetic pat...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-118-5-199303010-00004
更新日期:1993-03-01 00:00:00
abstract:BACKGROUND:Even with optimal pharmacotherapy, symptomatic heart failure is associated with substantial morbidity and mortality. PURPOSE:To determine the efficacy and safety of cardiac resynchronization therapy in adults with advanced systolic heart failure. DATA SOURCES:The Cochrane Central Register of Controlled Tri...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析,评审
doi:10.7326/0003-4819-141-5-200409070-00101
更新日期:2004-09-07 00:00:00
abstract:OBJECTIVE:To determine whether a statistical association exists between "low-count" bacteriuria (> 10(2) to 10(4) colony-forming units/mL) and acute urinary symptoms in young women. DESIGN:Prospective, case-control study. SETTING:Gynecology clinic at a student health center. PATIENTS:Women with or without urinary or...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-119-6-199309150-00002
更新日期:1993-09-15 00:00:00
abstract::Opioid dependence is a chronic relapsing medical condition with substantial health and societal complications. Recent federal initiatives are designed to enhance the medical treatment of patients with opioid dependence and will expand the role of internists in the care of these patients. These initiatives include a pr...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-137-8-200210150-00014
更新日期:2002-10-15 00:00:00
abstract::Determining the patient's major reasons for seeking care is of critical importance in a successful medical encounter. To study the physician's role in soliciting and developing the patient's concerns at the outset of a clinical encounter, 74 office visits were recorded. In only 17 (23%) of the visits was the patient p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-101-5-692
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and efficacy of all-trans retinoic acid to induce complete remission and to examine its effects on duration of remission and survival in patients with acute promyelocytic leukemia. DESIGN:Phase II evaluation and comparison with historical control patients. SETTING:Tertiary care cancer...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-120-4-199402150-00004
更新日期:1994-02-15 00:00:00
abstract::Elevated serum digoxin concentrations and clinical toxicity have been reported in patients receiving quinidine. The present study was undertaken to ascertain whether a similar interaction occurs between quinidine and another cardiac glycoside, digitoxin, and if so to evaluate the pharmacokinetic basis in five healthy ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-94-1-35
更新日期:1981-01-01 00:00:00
abstract::In two patients with thyroiditis caused by Coccidioides immitis, presented thyroid symptoms and findings were characteristic of subacute thyroiditis. Fine needle aspiration biopsy of the thyroid proved useful in establishing the diagnosis of coccidioidomycosis. This is the first report of coccidioidomycosis presenting...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-3-409
更新日期:1979-09-01 00:00:00
abstract::Our review focuses on low density lipoprotein (LD lipoprotein) and very low density lipoprotein (VLD lipoprotein) in their roles as transporters of cholesterol and triglyceride and as factors contributing to premature arteriovascular disease. We describe the clinical manifestations of the common, primary hyperlipoprot...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-85-4-497
更新日期:1976-10-01 00:00:00
abstract::Amantadine HCl administration has resulted in accelerated resolution of influenza A illness. Prolonged abnormalities in pulmonary function have been described in uncomplicated influenza A. To study the effect of amantadine on these changes, we evaluated young adults with documented natural influenza A with clear chest...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-85-2-177
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:The optimal strategy for diagnosis of deep venous thrombosis (DVT) is less well established for the upper extremities than for the lower extremities. Duplex color ultrasonography can be difficult to perform in the upper extremities because of their anatomy, and contrast venography is often indicated. Moreove...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-136-12-200206180-00007
更新日期:2002-06-18 00:00:00
abstract:BACKGROUND:AL amyloidosis is a fatal disease resulting from tissue deposition of amyloid fibrils derived from monoclonal immunoglobulin light chains. Treatment with oral chemotherapy is minimally effective. OBJECTIVE:To test survival and organ response in a large sample of patients treated with high-dose intravenous m...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章
doi:10.7326/0003-4819-140-2-200401200-00008
更新日期:2004-01-20 00:00:00
abstract:BACKGROUND:Introduction of a universal varicella vaccine program for U.S. children in 1996 sparked concern that less-frequent exposure to varicella would decrease external boosting of immunity to varicella zoster virus and thereby increase incidence of herpes zoster (HZ). OBJECTIVE:To determine whether the varicella v...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-159-11-201312030-00006
更新日期:2013-12-03 00:00:00
abstract:PURPOSE:To review the electropharmacology, clinical applications, side effects, and hemodynamic profile of intravenous amiodarone. DATA SOURCES:The MEDLINE database was searched for English-language material, including reports of clinical trials and in vivo studies, review articles, and abstracts presented at national...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-127-4-199708150-00007
更新日期:1997-08-15 00:00:00
abstract:BACKGROUND:The Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 global treatment target aims to achieve 73% virologic suppression among HIV-infected persons worldwide by 2020. OBJECTIVE:To estimate the clinical and economic value of reaching this ambitious goal in South Africa, by using a microsimulation m...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M16-0799
更新日期:2016-09-06 00:00:00
abstract::Although thyroid nodules are common, few are malignant and require surgical treatment. A systematic approach to their evaluation is important to avoid unnecessary surgery. Fine-needle aspiration biopsy has resulted in substantial improvements in diagnostic accuracy, cost reductions, and higher malignancy yield at time...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-142-11-200506070-00011
更新日期:2005-06-07 00:00:00
abstract:BACKGROUND:Medical students may be at high risk for occupational exposures to blood. OBJECTIVE:To measure the frequency of medical students' exposure to infectious body substances, to identify factors that affect the probability of such exposure, and to suggest targets for the prevention of such exposure. DESIGN:Revi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-130-1-199901050-00009
更新日期:1999-01-05 00:00:00
abstract:BACKGROUND:Screening programs using conventional cytology have successfully reduced cervical cancer, but newer tests might enhance screening. PURPOSE:To systematically review the evidence on liquid-based cytology (LBC) and high-risk human papillomavirus (HPV) screening for U.S. Preventive Services Task Force use in up...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-10-201111150-00376
更新日期:2011-11-15 00:00:00
abstract:Background:Stroke rates in patients with nonvalvular atrial fibrillation (AF) who are not receiving anticoagulant therapy vary widely across published studies; the resulting effect on the net clinical benefit of anticoagulation in AF is unknown. Objective:To determine the effect of variation in published AF stroke rat...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M17-2762
更新日期:2018-10-16 00:00:00
abstract::The U.S. Preventive Services Task Force (USPSTF) seeks to provide reliable and accurate evidence-based recommendations to primary care clinicians. However, clinicians indicate frustration with the lack of guidance provided by the USPSTF when the evidence is insufficient to make a recommendation. This article describes...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-150-3-200902030-00010
更新日期:2009-02-03 00:00:00
abstract:BACKGROUND:Although the efficacy of adjuvant chemotherapy in prolonging survival for women with breast cancer has been well documented, limited population-based information is available on the actual use of chemotherapy. OBJECTIVE:To examine the relationship between age and chemotherapy use. DESIGN:Cohort study. SET...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-138-2-200301210-00009
更新日期:2003-01-21 00:00:00
abstract::Streptococcus pneumoniae causes substantial morbidity and mortality. Incidence and severity are increased among populations with some chronic diseases. The currently available polyvalent polysaccharide vaccine induces antibody production among immunologically competent recipients against the 14 serotypes responsible f...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,评审
doi:10.7326/0003-4819-96-2-208
更新日期:1982-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether patients with Parkinson disease are at an increased risk for postoperative confusion. DESIGN:Retrospective chart review of patients with Parkinson disease who remained in the hospital at least 48 hours after their surgery. Current data were compared with published historical contro...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-111-3-218
更新日期:1989-08-01 00:00:00
abstract:BACKGROUND:Oral sildenafil and intravenous epoprostenol have independently been shown to be effective in patients with pulmonary arterial hypertension. OBJECTIVE:To investigate the effect of adding oral sildenafil to long-term intravenous epoprostenol in patients with pulmonary arterial hypertension. DESIGN:A 16-week...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-149-8-200810210-00004
更新日期:2008-10-21 00:00:00
abstract::Given the low mortality and morbidity of the severe acute respiratory syndrome (SARS) compared with other public health scourges, is the attention devoted to it misdirected? The SARS experience has provided at least 4 enduring lessons. First, by providing a test of the capacity of each part of the public health system...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-139-7-200310070-00011
更新日期:2003-10-07 00:00:00