title: J wave elevation to monitor quinidine efficacy in early repolarization syndrome.
abstract: We present the case of a 14-year-old female with early repolarization syndrome who presented with recurrent ventricular fibrillation and ICD shocks which were refractory to multiple drugs and catheter ablation. Treatment with quinidine, an Ito blocker, resulted in a normalization of J waves and suppression of VF. Interestingly, J wave amplitude correlated with the ventricular arrhythmia susceptibility and quinidine levels. The case highlights the importance of quinidine for management of ventricular arrhythmias in the context of early repolarisation and suggests that J wave amplitude may be an important indicator of therapeutic drug levels and arrhythmia susceptibility.
authors: Bordeaux University Hospital, F-33000 Bordeaux, France; Univ. Bordeaux, L'Institut de RYthmologie et de modelisation Cardiaque, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France. Electronic address: frederic.sacher@chu-bordeaux.fr.
authors: Frederic
authors: F
authors: Sacher
authors: Bordeaux University Hospital, F-33000 Bordeaux, France; Univ. Bordeaux, L'Institut de RYthmologie et de modelisation Cardiaque, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France.
authors: Nicolas
authors: N
authors: Derval
authors: University of Witten/Herdecke, Medical Center Porz am Rhein, Cologne, Germany.
authors: Marc
authors: M
authors: Horlitz
authors: Bordeaux University Hospital, F-33000 Bordeaux, France; Univ. Bordeaux, L'Institut de RYthmologie et de modelisation Cardiaque, Centre de recherche Cardio-Thoracique de Bordeaux, U1045, F-33000, Bordeaux, France.
authors: Michel
authors: M
authors: Haïssaguerre
mesh_terms: D000293:Adolescent; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000628:therapy; D053840:Brugada Syndrome; D000075224:Cardiac Conduction System Disease; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000002:abnormalities*; D006801:Humans; D011802:Quinidine / Q000627:therapeutic use*; D014693:Ventricular Fibrillation / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000889:Anti-Arrhythmia Agents; D011802:Quinidine
keywords: Early repolarization; Electrical storm; J wave elevation; Quinidine; Sudden cardiac death; Ventricular fibrillation