{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T05:40:18Z","timestamp":1760766018267,"version":"build-2065373602"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[1998,4,24]]},"published-print":{"date-parts":[[1998,9,1]]},"abstract":"<jats:p>A 64 year old woman with an 11 year history of paroxysmal atrial fibrillation presented to the emergency room because of palpitations that had started two weeks previously. She had used sotalol 80\u2009mg once daily for three years without any episodes of proarrhythmia or other adverse effects. However, she developed pronounced T wave alternans with giant inverted T waves and excessive QT prolongation following sotalol administration one day after conversion from atrial fibrillation to sinus rhythm. This case demonstrates bizarre T wave changes, T wave alternans, and extreme QT prolongation following sotalol administration shortly after conversion from atrial fibrillation to sinus rhythm. In this situation, sotalol administration may be proarrhythmic, because it enhances repolarisation inhomogeneities based on a spatially inhomogeneous distribution of repolarisation controlling ion channels to induce repolarisation abnormalities that may lead to torsade de pointes.<\/jats:p>","DOI":"10.1136\/hrt.80.3.303","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T15:31:45Z","timestamp":1413991905000},"page":"303-306","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["T wave alternans after sotalol: evidence for increased sensitivity to sotalol after conversion from atrial fibrillation to sinus rhythm"],"prefix":"10.1136","volume":"80","author":[{"given":"H L","family":"Tan","sequence":"first","affiliation":[{"name":"aDepartment of Cardiology, University of Amsterdam, Academic Medical Center, Amsterdam, Netherlands, \n\nbDepartment of Cardiology, Heart Lung Institute, Utrecht University Hospital, Utrecht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A A M","family":"Wilde","sequence":"additional","affiliation":[{"name":"aDepartment of Cardiology, University of Amsterdam, Academic Medical Center, Amsterdam, Netherlands, \n\nbDepartment of Cardiology, Heart Lung Institute, Utrecht University Hospital, Utrecht, Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1998,9,1]]},"reference":[{"key":"2025101722142854000_80.3.303.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1992.tb01104.x"},{"key":"2025101722142854000_80.3.303.2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.94.8.1996"},{"key":"2025101722142854000_80.3.303.3","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(75)90008-3"},{"key":"2025101722142854000_80.3.303.4","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1016\/0735-1097(94)90653-X","article-title":"T wave alternans in idiopathic long QT syndrome.","volume":"23","author":"Zareba","year":"1994","journal-title":"J Am Coll Cardiol"},{"key":"2025101722142854000_80.3.303.5","unstructured":"Schwartz PJ Locati E Priori SG (1990) The long Q-T syndrome. in Cardiac electrophysiology from cell to bedside. eds Zipes DP Jalife J (WB Saunders, Philadelphia), pp 589\u2013605."},{"key":"2025101722142854000_80.3.303.6","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/j.1540-8159.1992.tb03082.x","article-title":"TU alternans, long QTU, and torsade de pointes: clinical and experimental observations.","volume":"15","author":"Habbab","year":"1992","journal-title":"PACE"},{"key":"2025101722142854000_80.3.303.7","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(86)90010-4"},{"key":"2025101722142854000_80.3.303.8","first-page":"I-245","article-title":"Delayed adaptation of ventricular repolarization after conversion from atrial fibrillation\u2014a proarrhythmic risk factor? 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