Quinidine, a life-saving medication for brugada syndrome, is inaccessible in many countries

Sami Viskin, Arthur A.M. Wilde, Milton E. Guevara-Valdivia, Amin Daoulah, Andrew D. Krahn, Douglas P. Zipes, Amir Halkin, Kalyanam Shivkumar, Noel G. Boyle, Arnon Adler, Bernard Belhassen, Edgardo Schapachnik, Farhan Asrar, Raphael Rosso

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Objectives The aim of this study was to determine the availability of quinidine throughout the world. Background Quinidine is the only oral medication that is effective for preventing life-threatening ventricular arrhythmias due to Brugada syndrome and idiopathic ventricular fibrillation. However, because of its low price and restricted indication, this medication is not marketed in many countries. Methods We conducted a survey of the availability of quinidine by contacting professional medical societies and arrhythmia specialists worldwide. Physicians were e-mailed questionnaires requesting information concerning the quinidine preparation available at their hospital. We also requested information concerning cases of adverse arrhythmic events resulting from unavailability of quinidine. Results A total of 273 physicians from 131 countries provided information regarding the availability of quinidine. Quinidine was readily available in 19 countries (14%), not accessible in 99 countries (76%), and available only through specific regulatory processes that require 4 to 90 days for completion in 13 countries (10%). We were able to gather information concerning 22 patients who had serious arrhythmias probably related (10 cases) or possibility related (12 cases) to the absence of quinidine, including 2 fatalities possibly attributable to the unavailability of quinidine. Conclusions The lack of accessibility of quinidine is a serious medical hazard at the global level.

Original languageEnglish (US)
Pages (from-to)2383-2387
Number of pages5
JournalJournal of the American College of Cardiology
Issue number23
StatePublished - Jun 11 2013


  • arrhythmic storm
  • Brugada syndrome
  • idiopathic ventricular fibrillation
  • implantable cardioverter-defibrillator
  • quinidine
  • ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Viskin, S., Wilde, A. A. M., Guevara-Valdivia, M. E., Daoulah, A., Krahn, A. D., Zipes, D. P., Halkin, A., Shivkumar, K., Boyle, N. G., Adler, A., Belhassen, B., Schapachnik, E., Asrar, F., & Rosso, R. (2013). Quinidine, a life-saving medication for brugada syndrome, is inaccessible in many countries. Journal of the American College of Cardiology, 61(23), 2383-2387. https://doi.org/10.1016/j.jacc.2013.02.077