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Quinidine in the Management of Recurrent Ventricular Arrhythmias

Quinidine was the most frequently used antiarrhythmic drug in the 80s (among other reasons, because there were few alternative choices available). In the 90s, newer antiarrhythmic medications became available at a time when the adverse (proarrhythmic) effects of quinidine became increasingly recognized. A meta-analysis of studies on atrial fibrillation, published in 1990, demonstrated an increased mortality risk for quinidine-treated patients. As the interest in new drugs increased, the demand for quinidine shrank. Eventually, market forces persuaded manufacturers of quinidine to cease its production... Ironically, quinidine disappeared from the market just as new studies were showing that…

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Articles of Interest

Efficacy of Quinidine in High-Risk Patients With Brugada Syndrome

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.

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GoodRx

Quinidine is one of the oldest antiarrhythmic medications, but isn't used as often these days since there are better alternatives.

StatPearls

Quinidine is well known for its toxicity, causing QT prolongation and, in severe cases, a pleomorphic arrhythmia, a.k.a. "Torsades de pointes." This condition can be fatal, and the management of the situation includes discontinuation of the drug, institution of cardiac and electrolyte (potassium and magnesium) monitoring, management of hypoxia. Clinicians can promptly manage torsades de pointes by giving magnesium sulfate and terminating prolonged episodes by electrical cardioversion; in refractory cases, isoproterenol or transvenous pacing is an option.