Ionic basis of pharmacological therapy 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
Manlio F
MF
Department of Electrocardiology, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F., México. manliomarquez@yahoo.com
Salica
Gabriel
G
Hermosillo
Antonio G
AG
Pastelín
Gustavo
G
Gómez-Flores
Jorge
J
Nava
Santiago
S
Cárdenas
Manuel
M
D000284:Administration, Oral; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D053840:Brugada Syndrome / Q000188:drug therapy* / Q000503:physiopathology*; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D015640:Ion Channel Gating / Q000187:drug effects*; D007473:Ion Channels / Q000187:drug effects*; D008955:Models, Cardiovascular
D000889:Anti-Arrhythmia Agents; D007473:Ion Channels