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J Am Coll Cardiol. 2013 Jun 11;61(23):2383-7. doi: 10.1016/j.jacc.2013.02.077. Epub 2013 Apr 10.

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

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1
Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. samiviskin@gmail.com

Abstract

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.

PMID:
23583244
DOI:
10.1016/j.jacc.2013.02.077
[Indexed for MEDLINE]
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