Quinidine Syncope

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Abstract
This is a report of 36 syncopal attacks occurring in 8 patients undergoing quinidine therapy for chronic atrial arrhythmias. These attacks represent ventricular flutter or fibrillation, as has been documented in the majority of the cases. They are believed to represent specific sensitization of the myocardium by quinidine, hence the term "quinidine syncope" is used. The attacks are most likely to occur 1 to 3 hours after administration of quinidine and are usually paroxysmal in nature, with spontaneous termination within the time limits of complete recovery. They have a tendency to periodic recurrence over a period of several hours. Quinidine syncope has not been found to be associated with other toxic quinidine effects and did not necessarily occur after large doses of quinidine, in association with high quinidine blood levels. It is believed that paroxysmal ventricular fibrillation represents a common, frequently unrecognized, complication of quinidine therapy.