Efficacy of quinidine in high-risk patients with Brugada syndrome
Efficacy of quinidine in high-risk patients with Brugada syndrome
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DOI：
10.1161/01.cir.0000143159.30585.90
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发表时间：
2004-09-28
期刊：
影响因子：
37.8
通讯作者：
Viskin, S
中科院分区：
文献类型：
--
作者：
Belhassen, B;Glick, A;Viskin, S
背景-自动植入式心律转复除颤器治疗被认为是Brugada综合征高危患者的唯一有效治疗方法。奎尼丁抑制I-to电流，这可能在这种疾病的发病机制中发挥重要作用。方法和结果-硫酸氢奎尼丁（平均剂量，1483+/-240毫克）对预防可诱导和自发性心室颤动（VF）的影响进行了前瞻性评估，在25例（24名男性，1名女性;年龄，19至80岁）与Brugada综合征。有症状患者15例（包括7例心脏骤停幸存者和7例不明原因晕厥患者），无症状患者10例。所有25例患者在基线电生理检查时均存在可诱导VF。奎尼丁在25例患者中的22例（88%）中阻止了VF诱导。随访6个月至22.2年，所有患者均存活。19例患者接受奎尼丁治疗6至219个月（平均值+/-SD，56+/-67个月）。无一例发生心律失常事件，但2例发生非心律失常相关晕厥。奎尼丁的管理与36%的副作用，解决后停药conclusions奎尼丁有效地防止室颤诱导Brugada综合征患者的发病率。我们的数据表明，奎尼丁也抑制自发性心律失常，并可能被证明是一个安全的替代自动植入式心律转复除颤器治疗的相当一部分患者与Brugada综合征。比较这两种疗法的随机研究似乎是必要的。
Background-Automatic implantable cardioverter-defibrillator therapy is considered the only effective treatment for high-risk patients with Brugada syndrome. Quinidine depresses I-to current, which may play an important role in the arrhythmogenesis of this disease.Methods and Results-The effects of quinidine bisulfate (mean dose, 1483+/-240 mg) on the prevention of inducible and spontaneous ventricular fibrillation (VF) were prospectively evaluated in 25 patients (24 men, 1 woman; age, 19 to 80 years) with Brugada syndrome. There were 15 symptomatic patients (including 7 cardiac arrest survivors and 7 patients with unexplained syncope) and 10 asymptomatic patients. All 25 patients had inducible VF at baseline electrophysiological study. Quinidine prevented VF induction in 22 of the 25 patients (88%). After a follow-up period of 6 months to 22.2 years, all patients are alive. Nineteen patients were treated with quinidine for 6 to 219 months (mean+/-SD, 56+/-67 months). None had an arrhythmic event, although 2 had non-arrhythmia-related syncope. Administration of quinidine was associated with a 36% incidence of side effects that resolved after drug discontinuation.Conclusions-Quinidine effectively prevents VF induction in patients with Brugada syndrome. Our data suggest that quinidine also suppresses spontaneous arrhythmias and could prove to be a safe alternative to automatic implantable cardioverter-defibrillator therapy for a substantial proportion of patients with Brugada syndrome. Randomized studies comparing these two therapies seem warranted.