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J wave elevation to monitor quinidine efficacy in early repolarization syndrome.

Abstract
We present the case of a 14-year-old female with early repolarization syndrome who presented with recurrent ventricular fibrillation and ICD shocks which were refractory to multiple drugs and catheter ablation. Treatment with quinidine, an Ito blocker, resulted in a normalization of J waves and suppression of VF. Interestingly, J wave amplitude correlated with the ventricular arrhythmia susceptibility and quinidine levels. The case highlights the importance of quinidine for management of ventricular arrhythmias in the context of early repolarisation and suggests that J wave amplitude may be an important indicator of therapeutic drug levels and arrhythmia susceptibility.
AuthorsFrederic Sacher, Nicolas Derval, Marc Horlitz, Michel Haïssaguerre
JournalJournal of electrocardiology (J Electrocardiol) 2014 Mar-Apr Vol. 47 Issue 2 Pg. 223-5 ISSN: 1532-8430 [Electronic] United States
PMID24332747 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Anti-Arrhythmia Agents
  • Quinidine
Topics
  • Adolescent
  • Anti-Arrhythmia Agents (therapeutic use)
  • Arrhythmias, Cardiac (complications, therapy)
  • Brugada Syndrome
  • Cardiac Conduction System Disease
  • Defibrillators, Implantable
  • Electrocardiography
  • Female
  • Heart Conduction System (abnormalities)
  • Humans
  • Quinidine (therapeutic use)
  • Ventricular Fibrillation (drug therapy, etiology)

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