Effects of quinidine on atrioventricular nodal reentrant paroxysmal tachycardia

D. Wu, J. Hung, C. T. Kuo, K. S. Hsu

Research output: Contribution to journalJournal Article peer-review

31 Scopus citations

Abstract

Electrophysiologic studies were performed in 14 patients with atrioventricular nodal reentrant paroxysmal tachycardia (PSVT) before and after oral administration of 1.2-1.6 g quinidine sulfate over a 24-hour period (0.3-0.4 g every 6 hours). Studies were performed after 0.5-1 mg i.v. atropine before and after quinidine. All 14 patients had induction of sustained PSVT before quinidine, with or without atropine. After quinidine, 11 patients lost the ability to induce echoes or sustain PSVT, reflecting depression of the retograde pathway with either absence of atrial echoes (six patients) or induction of nonsustained PSVT, with termination of echoes or PSVT occurring after QRS (block in retrograde pathways) (five patients). In only one of these 11 patients was sustained PSVT inducible after addition of atropine. All 11 were discharged on the same dose of quinidine. In three patients, quinidine was discontinued because of side effects. Follow-up in the remaining eight patients for 8 ± 2 months showed no recurrence of sustained PSVT. Three of the 14 patients had unduction of sustained PSVT after quinidine. Ventricular paced cycle length producing ventriculoatrial block was 314 ± 7 msec (mean ± SEM) before and 392 ± 13 msec after quinidine (p<0.01) in the 14 patients, suggesting depression of the retrograde pathway with quinidine. In summary, quinidine inhibited induction of sustained atrioventricular nodal reentrant tachycardia with depression of the retrograde pathway. It is very effective in preventing recurrences of PSVT in most patients.

Original languageEnglish
Pages (from-to)823-831
Number of pages9
JournalCirculation
Volume64
Issue number4
DOIs
StatePublished - 1981
Externally publishedYes

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