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Quinidine syncope in children.

C L Webb, M Dick, A P Rocchini

    Journal of the American College of Cardiology
    |May 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

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    Children with heart disease taking quinidine are at higher risk for syncope. This cardiac arrhythmia drug can cause dangerous side effects, including fatal arrhythmias, in pediatric patients.

    Area of Science:

    • Pediatric Cardiology
    • Clinical Pharmacology
    • Cardiac Electrophysiology

    Background:

    • Quinidine syncope is a known complication in adult patients with cardiac arrhythmias.
    • Factors influencing quinidine syncope in pediatric populations are not well-defined.
    • Understanding these factors is crucial for safe and effective pediatric arrhythmia management.

    Purpose of the Study:

    • To identify clinical, electrocardiographic, and pharmacologic factors associated with quinidine syncope in children.
    • To compare characteristics of pediatric patients who experienced syncope versus those who did not while on quinidine therapy.

    Main Methods:

    • Retrospective comparison of clinical, anatomic, electrocardiographic, roentgenographic, and pharmacologic data.
    • Two groups were analyzed: six pediatric patients with syncope (Group A) and 22 without syncope (Group B).

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  • Statistical analysis included chi-square test for significant associations.

    • Main Results:

    • A significant association was found between heart disease and quinidine syncope in children (chi-square = 10.2, p = 0.001).
    • All syncopal patients (Group A) had heart disease, compared to 15/22 non-syncopal patients (Group B).
    • No significant differences were observed in age, quinidine serum concentration, or corrected QT interval between groups.
    • Two syncopal patients died, and two experienced hypokalemia; syncope occurred within 8 days of therapy initiation in three patients.
    • Ventricular arrhythmias, including sustained ventricular tachycardia, were observed in all syncopal patients.

    Conclusions:

    • Children with underlying heart disease are at a significantly higher risk for developing quinidine syncope.
    • Quinidine therapy in pediatric patients, especially those with structural heart disease, requires careful monitoring for syncope and arrhythmias.
    • Early recognition of syncope and associated arrhythmias is critical due to potential fatal outcomes.