Cardiology MCQ & Review
Q. Which of the following drugs is found to be useful in idiopathic ventricular fibrillation ?
A. Quinidine
B. Bisoprolol
C. Verapamil
D. Sotalol
Explanation:
Idiopathic ventricular fibrillation has a high recurrence rate.
The recommended therapy is implantation of implantable cardioverter defibrillator. Currently, recommendations for a specific drug therapy are not available.
Antiarrhythmic agents had no effect on the recurrence rate in the patients from the Unexplained Cardiac Arrest Registry of Europe
In a study by Belhassen et al.,patients with IVF have received oral quinidine guided by serial electrophysiological studies. In patients receiving continuous quinidine treatment, no recurrences of VF were reported during a mean follow-up period of 9.1 ± 5.6 years. In a subset of patients, these promising results were confirmed during longterm follow-up.
Currently pharmacologic therapy serves as an adjunct to ICD therapy in patients with multiple ICD discharges.
References:
1.Belhassen B, Viskin S, Fish R, et al: Effects of electrophysiologic-guided therapy with Class IA antiarrhythmic drugs on the long-term outcome of patients with idiopathic ventricular fibrillation with or without the Brugada syndrome. J Cardiovasc Electrophysiol 10:1301–1312, 1999.
2. Belhassen B, Glick A, Viskin S: Excellent longterm reproducibility of the electrophysiologic efficacy of quinidine in patients with idiopathic ventricular fibrillation and Brugada syndrome. Pacing Clin Electrophysiol 32:294–301, 2009.
Answer: A (Quinidine)
Keywords: Cardiology review, Cardiology, Multiple choice questions, medical students, Electrophysiology, Ventricular fibrillation