Open AccessLow‐Dose Quinidine Effectively Reduced Shocks in Brugada Syndrome Patients with an Implantable Cardioverter Defibrillator: A Chinese Case Series Report
Author(s) -
Shen Tongtong,
Yuan Binbin,
Geng Jie,
Chen Chun,
Zhou Xiujuan,
Shan Qijun
Publication year - 2017
Publication title -
annals of noninvasive electrocardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.494
H-Index - 48
eISSN - 1542-474X
pISSN - 1082-720X
DOI - 10.1111/anec.12375
Subject(s) - quinidine , medicine , brugada syndrome , ventricular fibrillation , implantable cardioverter defibrillator , cardiology , ventricular tachycardia , anesthesia
Background Only implantable cardioverter defibrillators ( ICD ) have been proven to prevent sudden cardiac death ( SCD ) in patients with Brugada syndrome (BrS). However, ICD discharge, whether appropriate or inappropriate, leads to impaired quality of life and even increases rehospitalization. Quinidine might prevent the recurrence of ventricular arrhythmia ( VA ); however, the effect of low‐dose quinidine for preventing spontaneous arrhythmias remains less clear. Methods In our cardiology center, 10 confirmed patients with BrS (all men, mean age 38.7 ± 6.72 years) who underwent appropriate ICD shocks due to recurrent VA s were treated with quinidine (≤200 mg/day) and followed regularly. Results All the patients underwent ICD shocks due to ventricular tachycardia ( VT )/ventricular fibrillation ( VF ) before taking quinidine. A 24‐hour distribution of VT / VF demonstrated that most of the events occurred in the sleeping time from 22:00 to 8:00. Quinidine prevented recurrence of VA s in nine patients. The other one patient took quinidine discontinuously because of anxiety suffered from less episodes of VA , and after psychological guidance, he took quinidine 200 mg/day and experienced no VA episodes from then on. In our series, only one patient suffered leukopenia related to quinidine. No other side effect was observed. Conclusions Quinidine with a very low dose (≤200 mg/day) well controlled VT / VF recurrence for a long‐term period in Chinese patients with BrS. Administration (at 21:00) according to the circadian distribution of VT / VF episodes might increase the efficiency and improve the patient's tolerance.