VENTRICULAR FIBRILLATION IN ACUTE CORONARY ARTERY THROMBOSIS DURING THE INTRAVENOUS ADMINISTRATION OF QUINIDINE SULPHATE; REPORT OF A FATAL CASE

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Abstract
A case of sudden death during the intraven. adm. of quinidine sulphate for ventricular tachycardia following the use of epinephrine in acute myocardial infarction caused by acute coronary artery occlusion is reported. The mechanism of death as recorded electrocardiographically was ventricular fibrillation. Because it is frequently impossible to predetermine the presence of disease of the junctional tissues, not only is the routine prophylactic use of quini-dine in acute myocardial infarction a hazardous procedure but the employment of the drug to control such ectopic rhythm as ventricular tachycardia may enhance the development of fatal ventricular fibrillation. Only when the acute myocardial reaction has subsided is there justification in risking quinidine, for then the marked irritability for a potential idio-ventricular rhythm is not present and the electrocardiographic absence of conduction defects as indicating a healthy conduction system can be reasonably accepted.