Successful use of quinidine in treatment of electrical storm in Brugada syndrome.
We report an adolescent with a malignant form of Brugada syndrome who presented with 15 episodes of ventricular fibrillation (VF) over 10 days, shortly after implantation of an implantable cardioverter defibrillator. Oral quinidine bisulphate at a dose of 1000 mg/day successfully suppressed the electrical storm and recurrence of VF over 18-month follow-up. It also normalized the ST-segment elevation in his right precordial leads, suppressed all ambient unifocal ventricular extrasystoles and induction of VF on programmed electrical stimulation. This case suggests that quinidine, by virtue of its blocking action on Ito, may be useful as adjunctive therapy in Brugada syndrome.
Mok
Ngai-Shing
NS
Cardiology Team, Department of Medicine and Geriatrics, Princess Margaret Hospital, Kowloon, Hong Kong, China. isaacmok@netvigator.com
Chan
Ngai-Yin
NY
Chiu
Alex Chi-Suen
AC
D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000188:drug therapy*; D003131:Combined Modality Therapy; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D017147:Defibrillators, Implantable; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000187:drug effects; D015716:Electrocardiography, Ambulatory / Q000187:drug effects; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011803:Quinine / Q000627:therapeutic use*; D012008:Recurrence; D013577:Syndrome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000188:drug therapy*; D018879:Ventricular Premature Complexes / Q000175:diagnosis / Q000188:drug therapy*
D000889:Anti-Arrhythmia Agents; D011803:Quinine