Quinidine syncope in children

Catherine L. Webb, Macdonald Dick, Albert P. Rocchini, A. Rebecca Snider, Dennis C. Crowley, Robert H. Beekman, Robert L Spicer, Amnon Rosenthal

Research output: Contribution to journalArticle

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Abstract

Quinidine syncope and factors associated with it are well known among adult patients treated for cardiac arrhythmias. To define factors that may influence the occurrence of syncope in children taking quinidine, the clinical, anatomic, electrocardiographic, roentgeno-graphic and pharmacologic data were compared in six patients with syncope (Group A) and 22 patients without syncope (Group B). There was a significant (chi-square = 10.2, p = 0.001) relation between heart disease and quinidine syncope: all six Group A (syncopal) patients had heart disease whereas 15 of the 22 Group B (non-syncopal) patients had no structural heart disease. In contrast, no significant difference was noted between Group A and Group B patients in mean age (11.4 versus 11.4 years), mean quinidine serum concentration (2.9 versus 2.3 μ/ml), mean corrected QT interval before quinidine (0.43 versus 0.40 second) or mean corrected QT interval during quinidine therapy (0.46 versus 0.46 second) or between those taking digitalis and those not. Two of the six Group A (syncopal) patients died during therapy, one 6 days after initiating therapy and one suddenly at home 6 months after beginning quinidine. Another two of the six Group A patients exhibited hypokalemia (both 2.9 mEq/liter) at the time of syncope, 2 weeks and 6 months, respectively, after initiation of quinidine therapy; both survived. Syncope occurred within 8 days of initiation of quinidine therapy in three of the six patients. Sustained ventricular tachycardia was observed during quinidine associated arrhythmia in three of six patients with syncope; nonsustained ventricular tachycardia or complex ventricular ectopic activity while on this therapy was observed before syncope in the other three patients in Group A. This experience indicates that quinidine-related syncope in children is more likely to occur in patients with structural heart disease, may be associated with hypokalemia, is a result of ventricular tachycardia and may be fatal. In the presence of heart disease, in-hospital observation during the first 14 days and maintenance of normokalemia is a prerequisite for quinidine therapy in children.

Original languageEnglish (US)
Pages (from-to)1031-1037
Number of pages7
JournalJournal of the American College of Cardiology
Volume9
Issue number5
DOIs
StatePublished - Jan 1 1987

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Quinidine
Syncope
Heart Diseases
Ventricular Tachycardia
Hypokalemia
Therapeutics
Cardiac Arrhythmias
Digitalis
Maintenance
Observation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Webb, C. L., Dick, M., Rocchini, A. P., Rebecca Snider, A., Crowley, D. C., Beekman, R. H., ... Rosenthal, A. (1987). Quinidine syncope in children. Journal of the American College of Cardiology, 9(5), 1031-1037. https://doi.org/10.1016/S0735-1097(87)80304-2

Quinidine syncope in children. / Webb, Catherine L.; Dick, Macdonald; Rocchini, Albert P.; Rebecca Snider, A.; Crowley, Dennis C.; Beekman, Robert H.; Spicer, Robert L; Rosenthal, Amnon.

In: Journal of the American College of Cardiology, Vol. 9, No. 5, 01.01.1987, p. 1031-1037.

Research output: Contribution to journalArticle

Webb, CL, Dick, M, Rocchini, AP, Rebecca Snider, A, Crowley, DC, Beekman, RH, Spicer, RL & Rosenthal, A 1987, 'Quinidine syncope in children', Journal of the American College of Cardiology, vol. 9, no. 5, pp. 1031-1037. https://doi.org/10.1016/S0735-1097(87)80304-2
Webb CL, Dick M, Rocchini AP, Rebecca Snider A, Crowley DC, Beekman RH et al. Quinidine syncope in children. Journal of the American College of Cardiology. 1987 Jan 1;9(5):1031-1037. https://doi.org/10.1016/S0735-1097(87)80304-2
Webb, Catherine L. ; Dick, Macdonald ; Rocchini, Albert P. ; Rebecca Snider, A. ; Crowley, Dennis C. ; Beekman, Robert H. ; Spicer, Robert L ; Rosenthal, Amnon. / Quinidine syncope in children. In: Journal of the American College of Cardiology. 1987 ; Vol. 9, No. 5. pp. 1031-1037.
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