Key result
Administration of quinidine caused normalization of the ECG in two patients with Brugada syndrome, whereas flecainide induced malignant ventricular extrasystoles in one patient.
Why the study?
Does quinidine normalize the ECG in patients with Brugada syndrome?
Case Report (n=2)
Does quinidine normalize the ECG in patients with Brugada syndrome?
This is the first clinical report demonstrating that quinidine can normalize the ECG in patients with Brugada syndrome.
Answers are grounded in this paper and cite their sources.
Quinidine may normalize ECG in Brugada syndrome; hypothesis-generating observation requiring prospective validation.
Two patients with Brugada syndrome are presented. The ECGs showed right precordial J waves and ST-segment elevation. Patient 1 was resuscitated from nocturnal ventricular fibrillation, patient 2 was asymptomatic. In only patient 1, flecainide was infused causing monomorphic "malignant" ventricular extrasystoles (R on T), demonstrating the deleterious effect of Class IC antiarrhythmic drugs in Brugada syndrome. However, administration of the Class Ia antiarrhythmic drug quinidine caused normalization of the ECG in both patients. Based on in vitro experiments, agents that reduce the magnitude of Ito-mediated phase 1 have been suggested to normalize ST-segment elevation in Brugada syndrome. This is the first clinical report of such a quinidine induced ECG normalization.
No takes yet. Share an insight, caveat, or question.
Alings et al. (2001) conducted a case report in Brugada syndrome (n=2). Quinidine was evaluated on Electrocardiographic normalization. Administration of quinidine caused normalization of the ECG in two patients with Brugada syndrome, whereas flecainide induced malignant ventricular extrasystoles in one patient.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: