Successful use of quinidine in treatment of electrical storm in Brugada syndrome

We report on adolescent with a malignant form of Brugado syndrome who presented with 15 episodes of ventricular fibrillation (VF) over 10 days, shortly after implantation of on implantable cardioverter defibrillator. Oral quinidine bisulphate at a dose of 1000mg/day successfully suppressed the electrical storm and recurrence of VF over 18-month follow-up. It also normalized the ST-segment elevation in his right precordial leads, suppressed all ambient unifocal ventricular extrasystoles and induction of VF on programmed electrical stimulation. This case suggests that quinidine, by virtue of its blocking action on Ito, may be useful as adjunctive therapy in Brugada syndrome.