Quinidine-A legacy within the modern era of antiarrhythmic therapy

Pharmacol Res. 2019 Jun:144:257-263. doi: 10.1016/j.phrs.2019.04.028. Epub 2019 Apr 23.

Abstract

Quinidine has a very long history as antiarrhythmic medication. The alkaloid has been used in the treatment of almost all cardiac arrhythmias, especially atrial fibrillation, since the early twentieth century. Despite decreases in clinical prescription over the last two decades, mainly due to side effects like pro-arrhythmia, leading to increased mortality and to the availability of newer anti-arrhythmic drugs and catheter ablation, Quinidine remains an invaluable drug in the modern era of antiarrhythmic therapy. We present a review of the pharmacological properties of quinidine and its pivotal therapeutic role in the treatment of life-threatening arrhythmic storms in patients with congenital arrhythmogenic syndromes like Brugada's syndrome, early repolarization syndrome, short QT syndrome and idiopathic ventricular fibrillation.

Keywords: Antiarrhythmic drug therapy; Brugada syndrome; Channellopathies; Implantable cardioverter defibrillator; Primary electrical disease; Quinidine; Sudden cardiac death; Syncope; Ventricular fibrillation.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Arrhythmia Agents / pharmacology
  • Anti-Arrhythmia Agents / therapeutic use*
  • Arrhythmias, Cardiac / drug therapy*
  • Brugada Syndrome / drug therapy*
  • Humans
  • Quinidine / pharmacology
  • Quinidine / therapeutic use*
  • Ventricular Fibrillation / drug therapy*

Substances

  • Anti-Arrhythmia Agents
  • Quinidine

Supplementary concepts

  • Paroxysmal ventricular fibrillation
  • Short Qt Syndrome