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, Erdie C. Fadreguilan, Christian Veltman, G. Veerakul, Manlio Marquez, Rajnish Juneja, Amin Naseem DaoulahWalter Reyes Caorsi, Alejandron Cuesta, Henrik Kjaerulf Jensen, Adel Khalifa Sultan Hamad, Danna Spears, Ignacio Fernández Lozano, Víctor Castro Urda, R. Peinado, Prashanth Panduranga, Zahra Emkanjoo, Len Bergfeldt, Jan Janousek

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Abstract

The aim of this study was to determine the availability of quinidine throughout the world. 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. 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. 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. The lack of accessibility of quinidine is a serious medical hazard at the global level
Original languageEnglish
Pages (from-to)2383-2387
JournalJournal of the American College of Cardiology
Volume61
Issue number23
DOIs
Publication statusPublished - 2013

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