Key result
Short-term quinidine sulfate administration had variable effects on ST-segment elevation in Brugada syndrome, attenuating it in 3 patients, augmenting it in 3, and having no effect in 2.
Why the study?
Does short-term quinidine sulfate administration alter ST-segment elevation in patients with Brugada syndrome?
Observational (n=8)
Does short-term quinidine sulfate administration alter ST-segment elevation in patients with Brugada syndrome?
Short-term quinidine administration has variable electrocardiographic effects in Brugada syndrome, with potential to augment ST-segment elevation in some patients.
Variable quinidine effects on Brugada ST elevation urge caution in use; leaves open its role for prospective study.
Quinidine, a class I antiarrhythmic agent with blocking property of transient outward current, is a possible candidate for the suppression of ventricular fibrillation in patients with Brugada syndrome; although there is a concern that its ability to these effects may be proarrhythmic. Therefore, we evaluated the effect of quinidine sulfate on ST-segment elevation in Brugada syndrome. In 8 patients with Brugada syndrome, the magnitude of ST-elevation at the J-point (ST(J)), and the ST-segment configuration in leads V1-V3, were compared before and on day 2 after the initiation of quinidine administration. In 3 patients, quinidine attenuated ST(J) by > or = 0.1 mV. Of these 3 patients, ST-segment elevation was normalized in 2 patients, while the ST-segment configuration was unchanged in another. In another 3 patients, quinidine augmented ST(J) by > or = 0.1 mV without any change of ST-segment configuration, and the augmentation was returned to baseline after the discontinuation of quinidine. Quinidine exhibited no effect on the ST-segment in the remaining 2 patients. The favorable effects of quinidine on the ST-segment tended to be more pronounced in patients with prominent ST-elevation at baseline. In 1 patient, quinidine was effective in eliminating both ST-segment elevation and repetitive tachyarrhythmia episodes. In conclusion, the effects of quinidine on ST-segment elevation were variable. Quinidine may potentially augment the ST-segment elevation in some patients with Brugada syndrome.
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Watanabe et al. (2005) conducted an observational in Brugada syndrome (n=8). Quinidine sulfate vs. Baseline (before administration) was evaluated on Magnitude of ST-elevation at the J-point (ST(J)) and ST-segment configuration in leads V1-V3. Short-term quinidine sulfate administration had variable effects on ST-segment elevation in Brugada syndrome, attenuating it in 3 patients, augmenting it in 3, and having no effect in 2.
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