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Revision as of 16:48, 3 January 2015 editJytdog (talk | contribs)Autopatrolled, Extended confirmed users, Pending changes reviewers, Rollbackers187,951 edits add pmid← Previous edit Revision as of 16:49, 3 January 2015 edit undoJytdog (talk | contribs)Autopatrolled, Extended confirmed users, Pending changes reviewers, Rollbackers187,951 edits →Cocaine and omega-3 research: remove cocaine discussion. based on WP:PRIMARY source, and other people's work is cited as well. nothing to show that billman's work on cocaine in particular was noteworthyNext edit →
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Billman's model of SCD has also shown that sudden death is not a direct function of the degree of a myocardial infarction and that baroreflex gain declines during MI. Resistant dogs show a reduced heart rate during ischemia, while susceptible dogs show increased heart rate (beyond that induced by the exercise). Reviewing the findings, physiologist ] wrote that the model "seems to be extremely relevant" to human patients at risk for sudden cardiac death.<ref name=dynamic /> Billman's model of SCD has also shown that sudden death is not a direct function of the degree of a myocardial infarction and that baroreflex gain declines during MI. Resistant dogs show a reduced heart rate during ischemia, while susceptible dogs show increased heart rate (beyond that induced by the exercise). Reviewing the findings, physiologist ] wrote that the model "seems to be extremely relevant" to human patients at risk for sudden cardiac death.<ref name=dynamic />


===Cocaine and omega-3 research=== ===Omega-3 research===
During the early 1990s, Billman's work focused on the cardiovascular effects of ]. (Cardiovascular complications are the main cause of death associated with cocaine abuse.) His research demonstrated two primary effects of the drug – increased ] and cardiac ] inhibition – that lead to a variety of heart problems. The ion channel inhibition results in unusual ] including an elongated ]. The drug also causes increased heart rate and blood pressure. Secondary effects of cocaine demonstrated by Billman's research include arrhythmia, ], myocardial infarction, and ventricular fibrillation.<ref>{{cite journal|title=Inhibition of Human Ether-A-Go-Go Potassium Channels by Cocaine|author=Michael E. O’Leary|journal=Molecular Pharmacology|volume=59|number=2|year=2001|pages=269–277|pmid=11160863}}</ref>

] ]
In 1994, Billman used this technique to test the ability of omega-3 polyunsaturated fatty acids to prevent fatal arrhythmias. In the test, eight dogs otherwise susceptible to ventricular fibrillation were given a direct infusion of ]. Seven of the eight did not have VF during the test. Five of five animals re-tested in a follow-up control test (i.e. without treatment) had VF. The observed effect most likely resulted from a combination of direct chemical interaction on the cardiac cell membrane and a reduced heart rate caused by the omega-3s.<ref>{{cite journal|title=Prevention of ischemia-induced ventricular fibrillation by omega 3 fatty acids|journal=PNAS|date=May 10, 1994|volume=91|number=10|page=4427-4430|url=http://www.pnas.org/content/91/10/4427.abstract|author=G E Billman|author2=H Hallaq|author3=A Leaf}}</ref><ref name=wards /> The study was picked up by a nationally syndicated columnist, and thus reported in various popular media outlets.<ref name=wards>{{cite news|title=Fish Wards Off Erratic Heartbeats|author=Jean Carper|agency=King Features Syndicate|date=July 14, 1994|work=Chicago-Sun Times}}</ref> Follow-up studies in 1997 and 1999 confirmed the results (]<0.005) and found both ] and ] (found in fish oil), as well as ] (found in vegetable oil) to have antiarrhythmic effects.<ref>{{cite journal|title=Prevention of Fatal Arrhythmias in High-Risk Subjects by Fish Oil n-3 Fatty Acid Intake|author=Alexander Leaf|author2=Christine M. Albert|author3=Mark Josephson|author4=David Steinhaus|author5=Jeffrey Kluger|author6=Jing X. Kang|author7=Benjamin Cox|author8=Hui Zhang|author9=David Schoenfeld|journal=Circulation|volume=112|pages=2762-2768|doi=10.1161/CIRCULATIONAHA.105.549527|year=2005}}</ref><ref>{{cite journal|journal=Annual Review of Physiology|title=Medicine or Physiology: My Personal Mix|author=Alexander Leaf|volume=63|pages=1–14|doi=10.1146/annurev.physiol.63.1.1|date=March 2001}}</ref><ref>{{cite journal|title=Prevention of sudden cardiac death by dietary pure ω-3 polyunsaturated fatty acids in dogs|doi=10.1161/01.CIR.99.18.2452|journal=Circulation|date=1999|volume=99|page=2452-2457|author=George E. Billman|author2=Jing X. Kang|author3=Alexander Leaf}}</ref> In 1994, Billman used this technique to test the ability of omega-3 polyunsaturated fatty acids to prevent fatal arrhythmias. In the test, eight dogs otherwise susceptible to ventricular fibrillation were given a direct infusion of ]. Seven of the eight did not have VF during the test. Five of five animals re-tested in a follow-up control test (i.e. without treatment) had VF. The observed effect most likely resulted from a combination of direct chemical interaction on the cardiac cell membrane and a reduced heart rate caused by the omega-3s.<ref>{{cite journal|title=Prevention of ischemia-induced ventricular fibrillation by omega 3 fatty acids|journal=PNAS|date=May 10, 1994|volume=91|number=10|page=4427-4430|url=http://www.pnas.org/content/91/10/4427.abstract|author=G E Billman|author2=H Hallaq|author3=A Leaf}}</ref><ref name=wards /> The study was picked up by a nationally syndicated columnist, and thus reported in various popular media outlets.<ref name=wards>{{cite news|title=Fish Wards Off Erratic Heartbeats|author=Jean Carper|agency=King Features Syndicate|date=July 14, 1994|work=Chicago-Sun Times}}</ref> Follow-up studies in 1997 and 1999 confirmed the results (]<0.005) and found both ] and ] (found in fish oil), as well as ] (found in vegetable oil) to have antiarrhythmic effects.<ref>{{cite journal|title=Prevention of Fatal Arrhythmias in High-Risk Subjects by Fish Oil n-3 Fatty Acid Intake|author=Alexander Leaf|author2=Christine M. Albert|author3=Mark Josephson|author4=David Steinhaus|author5=Jeffrey Kluger|author6=Jing X. Kang|author7=Benjamin Cox|author8=Hui Zhang|author9=David Schoenfeld|journal=Circulation|volume=112|pages=2762-2768|doi=10.1161/CIRCULATIONAHA.105.549527|year=2005}}</ref><ref>{{cite journal|journal=Annual Review of Physiology|title=Medicine or Physiology: My Personal Mix|author=Alexander Leaf|volume=63|pages=1–14|doi=10.1146/annurev.physiol.63.1.1|date=March 2001}}</ref><ref>{{cite journal|title=Prevention of sudden cardiac death by dietary pure ω-3 polyunsaturated fatty acids in dogs|doi=10.1161/01.CIR.99.18.2452|journal=Circulation|date=1999|volume=99|page=2452-2457|author=George E. Billman|author2=Jing X. Kang|author3=Alexander Leaf}}</ref>

Revision as of 16:49, 3 January 2015

George Edward Billman
George Billman wearing a cowboy hat with empty beer cartons hung on the wall behind himBillman in his office in 2005
Born(1954-07-23)July 23, 1954
Fort Worth, Texas
CitizenshipUnited States
Alma materXavier University
University of Kentucky
Known forStudying the effects of exercise training and omega-3 fatty acids on the cardiovascular system
SpouseRosemary (1975–)
Children2
AwardsFellow – American Heart Association (2001)
Fellow – Heart Rhythm Society (2011)
Scientific career
FieldsPhysiology
InstitutionsUniversity of Oklahoma
Ohio State University
Thesis The Neural Control of the Coronary Circulation during Behavioral Stress in Conscious Dogs  (1980)
Doctoral advisorDavid C. Randall

George Edward Billman (born July 23, 1954) is an American physiologist and professor at Ohio State University. After receiving a Ph.D from the University of Kentucky in 1980, Billman began his professional career at the University of Oklahoma. In 1984, he joined the Ohio State staff, where he became an associate professor in 1990 and a full professor in 1996.

Billman's research has focused on cardiovascular function, in particular its role in the induction of ventricular fibrillation (VF). He developed non-invasive methods to study autonomic neural regulation of the heart, using a canine model of sudden cardiac death (SCD). These techniques have subsequently been used in human patients to identify people at high risk for VF. Billman has used his sudden cardiac death models to study the effects of exercise training on susceptibility to SCD and the effects of omega-3 fatty acids, among other things. Due to his use of live animals in experiments, Billman has been criticized by animal rights activists; a 2009 regulatory investigation found no evidence of wrongdoing.

Early life and education

George Edward Billman was born on July 23, 1954, in Fort Worth, Texas. He attended Xavier University, graduating cum laude in 1975 with a bachelor's degree in natural science. He did his doctoral work at the University of Kentucky, earning a Ph.D in physiology and biophysics in 1980. From 1980–1982, Billman was a research associate under H. Lowell Stone at the University of Oklahoma.

Career

In 1982, Billman was promoted to Assistant Professor of Research at Oklahoma. In 1984, he accepted an assistant professor position at the Ohio State University. He was promoted to associate professor in 1990 and made a full professor in 1996. Billman was elected a Fellow of the American Heart Association in 2001. In 2010, he was elected a Fellow of the Heart Rhythm Society. He is also a member of The Physiological Society in London, the American Physiological Society, the International Society for the Study of Fatty Acids and Lipids (ISSFAL), and Sigma Xi.

Billman has served on the editorial boards of the American Journal of Physiology: Regulatory, Integrative and Comparative Physiology (2004–2007), Current Cardiology Reviews (2004–), Experimental Physiology (2006−2010), the Journal of Cardiovascular Pharmacology (2001–), and the Journal of Applied Physiology (2007–). He was an associate editor of Pharmacology & Therapeutics from 1999–2014. In June 2014, he was selected as the editor-in-chief of the recently formed Frontiers in Physiology, a position he continues to hold as of 2014.

Billman consulted for Eli Lilly from 1987–1988, Glaxo from 1989–1991, Proctor & Gamble from 1995–99. He has been a consultant for Sanofi Aventis since 1999.

Research

Billman's research has focused on cardiovascular physiology with an emphasis on ventricular fibrillation (VF) and the cardiovascular system's response to stress. His work has led to non-invasive (electrocardiograph) techniques to detect susceptibility to sudden cardiac death (SCD) in dogs. These electrocardiographic markers have subsequently been used clinically on humans. Billman has also studied the effects of omega-3 fatty acids on the heart and circulatory system. He has performed experiments on live research dogs and using isolated ventricular myocytes.

Model of sudden cardiac death

Billman developed a technique of inducing fatal ventricular fibrillation in dogs in the lab of H. Lowell Stone starting in 1980, and used and refined it over the next 25 years. The model subsequently has been described as "an elegant in vivo model of sudden cardiac death" by cardiologist Michel de Lorgeril et al. and "a highly reliable canine model of sudden cardiac death" by physiologist Alexander Leaf et al. The model is described in Springer's handbook of reliable procedures for testing the potential effects of new drug candidates in the antiarrhythmic section.

In the procedure, the left main anterior coronary artery is surgically blocked and a hydraulic cuff is placed around the left circumflex coronary artery, allowing the artery to be blocked on demand. Experiments proceed after a month of recovery and treadmill training. Under stress from exercise combined with the blocking of the arteries, 50–60% of dogs enter fatal ventricular fibrillation within 2 minutes. These dogs are labeled susceptible, while the other 40–50% are labeled resistant. Dogs that enter VF are defibrillated, allowing for repeated study of the same animals. Over time, initial results (fibrillation or no fibrillation) have proven to be 92% reproducible, allowing for precise testing of potential antiarrhythmic agents.

This model of sudden cardiac death has "yielded important insights" into ischaemic heart disease. The initial study using the technique, published in 1982, found that decreased baroreflex sensitivity was associated with increased risk for ventricular fibrillation. This marked the first time an autonomic response was seen as having prognostic value. The same association was demonstrated in humans by Kleiger et al. in 1987 and "definitively" demonstrated in dogs in 1988 by Schwartz, Billman, et al. On the basis of these findings, a large clinical study (Autonomic Tone and Reflexes After MI), was conducted. The 1,284 patient study "fully confirmed" baroreflex sensitivity as a valid predictor of sudden and non-sudden death after myocardial infarction (MI).

Billman's model of SCD has also shown that sudden death is not a direct function of the degree of a myocardial infarction and that baroreflex gain declines during MI. Resistant dogs show a reduced heart rate during ischemia, while susceptible dogs show increased heart rate (beyond that induced by the exercise). Reviewing the findings, physiologist Dwain L. Eckberg wrote that the model "seems to be extremely relevant" to human patients at risk for sudden cardiac death.

Omega-3 research

Diagram showing the interaction between omega-3 fatty acids and the cardiac cell membrane (top) with the possible effect on ventricular arrhythmia (bottom).

In 1994, Billman used this technique to test the ability of omega-3 polyunsaturated fatty acids to prevent fatal arrhythmias. In the test, eight dogs otherwise susceptible to ventricular fibrillation were given a direct infusion of fish oil. Seven of the eight did not have VF during the test. Five of five animals re-tested in a follow-up control test (i.e. without treatment) had VF. The observed effect most likely resulted from a combination of direct chemical interaction on the cardiac cell membrane and a reduced heart rate caused by the omega-3s. The study was picked up by a nationally syndicated columnist, and thus reported in various popular media outlets. Follow-up studies in 1997 and 1999 confirmed the results (P<0.005) and found both eicosapentaenoic acid and docosahexaenoic acid (found in fish oil), as well as α-Linolenic acid (found in vegetable oil) to have antiarrhythmic effects.

The same effect has been shown to occur in humans by other researchers. Billman's more recent work has focused on discovering the biochemical mechanisms of the antiarrhythmic effects omega-3 fatty acids, and on whether the same protection can be gained through dietary omega-3 fatty acids. A 2003 review of the research suggested the effect was due to electrophysiological properties of free omega-3s in sarcolemma. Dietary fatty acids are incorporated into membrane phospholipids and are then released during ischemia, suggesting a possible mechanism whereby the cardiac muscle is more resistant to entering arrhythmia under stress. However, large-scale clinical trials of dietary omega-3s have been inconclusive, with some studies finding significant reduction in sudden cardiac death and others finding no effect. Meta-analysis performed in 2014, found statistically significant reduction in sudden cardiac death (odds ratio (OR) 0.86; confidence interval (CI) 0.76 to 0.98), while 2013 meta-analysis using a different data set found a non-statistically significant reduction (OR 0.82; CI 0.60 to 1.21).

Response to research

Billman's experiments have been protested by animal rights activists. In 2007, a local group known as Protect Our Earth's Treasures, spurred by Ohio State approving the use of up to 120 additional dogs, protested Billman's research. Specifically, they were against the surgical blocking of arteries in Billman's model of sudden cardiac death and the subsequent euthanizing of surviving animals for future study. In April 2009, PETA, which had long questioned Billman's techniques, filed formal complaints with the U.S. Department of Agriculture and the NIH's Office of Laboratory Animal Welfare. They alleged he was conducting redundant experiments and using unnecessarily cruel techniques. Ohio State said PETA's claims "grossly misrepresented and severely discounted the scientific merit and potential public health benefit of this work." Two federal investigations found no evidence of wrongdoing, but PETA continued to campaign against the experiments. In 2010, Ohio State issued an open letter in response to continued protest letters. In the statement, OSU said PETA was misleading the public by saying Billman's research was investigating the "obvious" fact that "exercise strengthens the heart" when the research was actually attempting to understand the biochemical and cellular mechanisms which lead to sudden cardiac death.

Billman received a new investigator award from National Institutes of Health (NIH) from 1983−1986. He was the principal investigator on NIH R01 grants starting in 1986, 1995, 2002, and 2007, and on a National Institute on Drug Abuse R01 grant starting in 1990. He has also led studies paid for by Hoffmann-La Roche, Merck, and Sanofi-Aventis.

Personal life

George Billman and his wife, Rosemary, have been married since 1975. The couple have two children – George T. and Elyse T. Billman is an avid amateur genealogist. Through his research, Billman determined that his ancestor, Hans Theobald Billmann, who emigrated to the United States in 1752, was unlikely to be the son of Hans David Billmann (emigrated 1732), a finding at odds with conclusions drawn by previous researchers. He coordinated a genetic study, and DNA analysis by Oxford Ancestors confirmed the two Billmanns were unlikely to be closely related (most recent common ancestor 1000-2000 years ago).

Honors

Publications

In 2011, Billman published a review article on heart rate variability, illustrated here by an electrocardiogram recording of canine heart beat.

Billman has authored or co-authored more than 150 scientific papers, which have been cited more than 5000 times in peer-reviewed research. According to Web of Science, he has an h-index of 38, with 11 papers receiving more than 100 citations. Billman's work has also been referenced in publications for the general public. Billman was the editor of the 2010 book Novel Therapeutic Targets for Antiarrhythmic Drugs published by John Wiley and Sons, and contributed three chapters to it. According to the publisher, the book describes the state of cardiac arrhythmia treatment, and future directions the research may take. In a review of the book, Peter R. Kowey praised Billman for " blue sky thinking" in his contributions.

Books

  • Shayne Cox Gad, ed. (2005). "Cardiac Sarcolemmal ATP-Sensitive Potassium Channel Antagonists: Novel Ischemia-Selective Antiarrhythmic Agents". Drug Discovery Handbook. John Wiley & Sons. ISBN 978-0-471-21384-0.
  • Stefan Dhein; et al., eds. (2005). "In-Vivo Models of Arrhythmias: a Canine Model of Sudden Cardiac Death". Practical Methods in Cardiovascular Research. Springer. ISBN 978-3-540-40763-8. {{cite book}}: Explicit use of et al. in: |editor= (help)
  • Novel Therapeutic Targets for Antiarrhythmic Drugs. (editor). John Wiley & Sons. 2010. ISBN 0470561408.
  • The Effects of Omega-3 Polyunsaturated Fatty Acids on Cardiac Rhythm: Antiarrhythmic, Proarrhythmic, Both or Neither? (editor). Frontiers. 2013. ISBN 2889190889.

Selected journal articles

References

  1. ^ "George E Billman biography". Frontiers Media. Retrieved November 21, 2014.
  2. ^ Katherine H. Nemeh, ed. (2008). "Billman, George Edward". American Men & Women of Science. Vol. 1.
  3. "OSUToday". Ohio State University. June 17, 2010. Retrieved December 29, 2014.
  4. ^ "George E. Billman, PhD". Ohio State. Retrieved November 24, 2014.
  5. ^ Peter J. Schwartz (2011). "Vagal Stimulation for Heart Diseases: From Animals to Men". Circulation Journal. 75 (1): 20–27. doi:10.1253/circj.CJ-10-1019.
  6. Carper, Jean (October 13, 1993). "Eating Fish Oil May Help Prevent Erratic Heartbeats". Chicago Sun-Times. Retrieved January 2, 2015 – via HighBeam Research. {{cite news}}: Unknown parameter |subscription= ignored (|url-access= suggested) (help)
  7. ^ Hans Vogel, ed. (2007). "A-5: Anti-Arrythmic Activity". Drug Discovery and Evaluation: Pharmacological Assays (3rd ed.). pp. 306–7. ISBN 9783540714200.
  8. George E. Billman (2006). "A comprehensive review and analysis of 25 years of data from an in vivo canine model of sudden cardiac death: implications for future anti-arrhythmic drug development". Pharmacol Ther. 111 (3): 808-35. PMID 16483666.
  9. ^ Michel de Lorgeril; Patricia Salen (2008). "Dietary Prevention of Coronary Heart Disease". Wild-Type Food in Health Promotion and Disease Prevention. Springer. ISBN 978-1-59745-330-1.
  10. ^ Alexander Leaf; Jiang X. Kang; Yong-Fu Xiao (2005). "Omega-3 Fatty Acids and Ventricular Arrhythmias". In Artemis P. Simopoulos (ed.). Nutrition and Fitness, Obesity, The Metabolic Syndrome, Cardiovascular Disease and Cancer (Vol 94). Karger Medical and Scientific Publishers. ISBN 3-8055-7945-4.
  11. Alexander Leaf; Jing X. Kang; Yong-Fu Xiao; George E. Billman (2003). "Clinical Prevention of Sudden Cardiac Deat=h by n-3 Polyunsaturated Fatty Acids and Mechanism of Prevention of Arrhythmias by n-3 Fish Oils". Circulation. 107: 2646–2652. doi:10.1161/01.CIR.0000069566.78305.33.
  12. ^ Dwain L. Eckberg (2008). "Arterial Baroreflexes in Ischaemic Heart Disease, and their role in sudden cardiac death". In Marek Malik; A. John Camm (eds.). Dynamic Electrocardiography. John Wiley & Sons.
  13. G E Billman; H Hallaq; A Leaf (May 10, 1994). "Prevention of ischemia-induced ventricular fibrillation by omega 3 fatty acids". PNAS. 91 (10): 4427-4430.
  14. ^ Jean Carper (July 14, 1994). "Fish Wards Off Erratic Heartbeats". Chicago-Sun Times. King Features Syndicate.
  15. Alexander Leaf; Christine M. Albert; Mark Josephson; David Steinhaus; Jeffrey Kluger; Jing X. Kang; Benjamin Cox; Hui Zhang; David Schoenfeld (2005). "Prevention of Fatal Arrhythmias in High-Risk Subjects by Fish Oil n-3 Fatty Acid Intake". Circulation. 112: 2762–2768. doi:10.1161/CIRCULATIONAHA.105.549527.
  16. Alexander Leaf (March 2001). "Medicine or Physiology: My Personal Mix". Annual Review of Physiology. 63: 1–14. doi:10.1146/annurev.physiol.63.1.1.
  17. George E. Billman; Jing X. Kang; Alexander Leaf (1999). "Prevention of sudden cardiac death by dietary pure ω-3 polyunsaturated fatty acids in dogs". Circulation. 99: 2452-2457. doi:10.1161/01.CIR.99.18.2452.
  18. ^ Earle Holland (April 15, 2009). "Background on Billman's Heart Studies Involving the Use of Dogs". Ohio State University.
  19. Y.T. Wena; J.H. Daib; Q. Gaoa (May 2014). "Effects of Omega-3 fatty acid on major cardiovascular events and mortality in patients with coronary heart disease: A meta-analysis of randomized controlled trials". Nutrition, Metabolism and Cardiovascular Diseases. 24 (5): 470–475. doi:10.1016/j.numecd.2013.12.004.
  20. G Khoueiry; N Abi Rafeh; E Sullivan; F Saiful; Z Jaffery; DN Kenigsberg; SC Krishnan; S Khanal; S Bekheit; M Kowalski (July–August 2013). "Do omega-3 polyunsaturated fatty acids reduce risk of sudden cardiac death and ventricular arrhythmias? A meta-analysis of randomized trials". Heart & Lung. 42 (4): 251–6. doi:10.1016/j.hrtlng.2013.03.006.{{cite journal}}: CS1 maint: date format (link)
  21. ^ Charlie Boss (May 12, 2007). "Research on dogs at OSU protested". The Columbus Dispatch. p. 1B – via HighBeam Research. {{cite news}}: Cite has empty unknown parameter: |1= (help)
  22. ^ Richard Oviatt (April 23, 2009). "Ohio State U. abuses dogs, PETA says". The Lantern.
  23. ^ Charlie Boss (June 25, 2009). "Feds clear OSU researcher of dog-cruelty allegations". The Columbus Dispatch. p. 1B.
  24. ^ "An Open Letter from Ohio State University". Ohio State University. August 26, 2010. Retrieved December 10, 2014.
  25. Alice Thomas (March 18, 2004). "OSU Lands Noted Cancer Researcher". The Columbus Dispatch. p. 1B.
  26. George Billman. "The Billman/Bielmann Story". Oxford Ancestry. Retrieved December 22, 2014.
  27. "FHRS Member Listing". Heart Rhythm Society. Retrieved January 2, 2015.
  28. "Billman, GE Citation Report", Web of Science, 5.15, Thomas Reuters, 2014
  29. Herb Joiner-Bey (2004). The Healing Power of Flax. Freedom Press. ISBN 9781893910324.
  30. Lesley Braun; Marc Cohen (2010). Herbs and Natural Supplements. Elsevier Health Sciences. ISBN 9780729579100.
  31. Better Nutrition. Vol. 62, no. 12. December 2000. ISSN 0405-668X. {{cite magazine}}: Missing or empty |title= (help)
  32. Andrew L. Stoll (2001). The Omega-3 Connection. Simon and Schuster. ISBN 9780743217200.
  33. "Description of Novel Therapeutic Targets for Antiarrhythmic Drugs". John Wiley and Sons. Retrieved December 11, 2014.
  34. Peter R. Kowey (2011). "Book Review: Novel Therapeutic Targets for Antiarrhythmic Drugs". Circulation. 123: e241–e242. doi:10.1161/CIRCULATIONAHA.110.980037.

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