Pharmacological therapies including quinidine and isoproterenol may be beneficial in preventing arrhythmic episodes and managing arrhythmic storms in patients with Brugada syndrome.
Does pharmacological therapy prevent arrhythmic episodes in patients with Brugada syndrome?
This review summarizes the mechanistic rationale and clinical evidence for pharmacological therapies, such as quinidine and isoproterenol, in managing ventricular arrhythmias in Brugada syndrome.
An implantable cardioverter-defibrillator is considered the only effective therapy to terminate ventricular arrhythmias in symptomatic patients with Brugada syndrome. However, it does not prevent future arrhythmic episodes. Only antiarrhythmic drug therapy can prevent them. There have been several reports of a beneficial effect of oral quinidine in both asymptomatic and symptomatic patients. Other possible beneficial oral agents could be I(to) blockers. Intravenous isoproterenol has been reported to be especially useful in abolishing arrhythmic storms in emergency situations. Also, isolated case reports on the usefulness of cilostazol, sotalol, and mexiletine have been described. The present article reviews the mechanisms by which these drugs may act and their possible role in the pharmacotherapy of this disease.
Márquez et al. (Wed,) conducted a review in Brugada syndrome. Pharmacological therapy (quinidine, isoproterenol, cilostazol, sotalol, mexiletine) was evaluated. Pharmacological therapies including quinidine and isoproterenol may be beneficial in preventing arrhythmic episodes and managing arrhythmic storms in patients with Brugada syndrome.