Variable electrocardiographic effects of short-term quinidine sulfate administration in Brugada syndrome
Variable electrocardiographic effects of short-term quinidine sulfate administration in Brugada syndrome
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DOI：
10.1111/j.1540-8159.2005.09494.x
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发表时间：
2005-05-01
影响因子：
1.8
通讯作者：
Aizawa, Y
中科院分区：
文献类型：
--
作者：
Watanabe, H;Chinushi, M;Aizawa, Y
奎尼丁是一种 I 类抗心律失常药物，具有阻断瞬时外向电流的特性，可能是抑制 Brugada 综合征患者心室颤动的候选药物；尽管有人担心它产生这些作用的能力可能会导致心律失常。因此，我们评估了硫酸奎尼丁对 Brugada 综合征 ST 段抬高的影响。在 8 名 Brugada 综合征患者中，比较了奎尼丁给药前和给药后第 2 天的 I 点 (STJ) 的 ST 抬高幅度以及 V1-V3 导联的 ST 段配置。在 3 名患者中，奎尼丁使 STJ 减弱 >= 0.1 mV。在这 3 名患者中，2 名患者 ST 段抬高正常化，而另一名患者 ST 段构型未改变。另外 3 例患者，奎尼丁使 STJ 增强≥0.1 mV，ST 段构型没有任何改变，奎尼丁停药后增强恢复至基线。奎尼丁对其余 2 名患者的 ST 段没有影响。奎尼丁对 ST 段的有利影响在基线时 ST 段抬高明显的患者中更为明显。在 1 名患者中，奎尼丁可有效消除 ST 段抬高和重复性快速心律失常发作。总之，奎尼丁对 ST 段抬高的影响是可变的。奎尼丁可能会加剧某些布鲁格达综合征患者的 ST 段抬高。
Quinidine, a class I antiarrhythmic agent with blocking property of transient outward current, is a possible candidate for the suppression of ventricular fibrillation in patients with Brugada syndrome; although there is a concern that its ability to these effects may be proarrhythmic. Therefore, we evaluated the effect of quinidine sulfate on ST-segment elevation in Brugada syndrome. In 8 patients with Brugada syndrome, the magnitude of ST-elevation at the I-point (STJ), and the ST-segment configuration in leads V1-V3, were compared before and on day 2 after the initiation of quinidine administration. In 3 patients, quinidine attenuated STJ by >= 0.1 mV Of these 3 patients, ST-segment elevation was normalized in 2 patients, while the ST-segment configuration was unchanged in another. In another 3 patients, quinidine augmented STJ by >= 0.1 mV without any change of ST-segment configuration, and the augmentation was returned to baseline after the discontinuation of quinidine. Quinidine exhibited no effect on the ST-segment in the remaining 2 patients. The favorable effects of quinidine on the ST-segment tended to be more pronounced in patients with prominent ST-elevution at baseline. In 1 patient, quinidine was effective in eliminating both ST-segment elevation and repetitive tachyarrhythmia episodes. In conclusion, the effects of quinidine on ST-segment elevation were variable. Quinidine may potentially augment the ST-segment elevation in some patients with Brugada syndrome.