Morganroth J, Horowitz L N
Am J Cardiol. 1985 Oct 1;56(10):585-7. doi: 10.1016/0002-9149(85)91015-x.
To determine the prevalence and importance of proarrhythmic events secondary to the initiation of quinidine therapy in outpatients with benign or potentially lethal ventricular arrhythmias, the data from 360 patients treated with quinidine as part of 3 outpatient drug trials were retrospectively reviewed. These patients had at least 30 ventricular premature complexes per hour during placebo treatment and had no evidence of unstable clinical states, hypokalemia, digitalis toxicity, atrial fibrillation or a prolonged QT interval (longer than 0.50 second). The quinidine dose varied from 200 to 400 mg 4 times a day for 2 to 4 weeks. Proarrhythmic effect was defined on Holter monitoring as a 400% increase in frequency of ventricular premature complexes, the presence of new ventricular tachycardia not previously identified or a 10-fold increase in the number of beats of ventricular tachycardia. There was no difference in the demography, response to quinidine therapy or side effects on quinidine among the 3 trials. Six of 360 patients (2%) had a proarrhythmic response and none of these patients had hemodynamic symptoms, required hospitalization or died from the proarrhythmic event. Thus, quinidine can be safely initiated to outpatients who meet the inclusion criteria cited herein.
为了确定在患有良性或潜在致命性室性心律失常的门诊患者中，开始使用奎尼丁治疗后发生致心律失常事件的发生率及其重要性，我们回顾性分析了360例作为3项门诊药物试验一部分接受奎尼丁治疗的患者的数据。这些患者在安慰剂治疗期间每小时至少有30次室性早搏，且没有临床状态不稳定、低钾血症、洋地黄中毒、房颤或QT间期延长（超过0.50秒）的证据。奎尼丁剂量为每日4次，每次200至400毫克，持续2至4周。动态心电图监测将致心律失常效应定义为室性早搏频率增加400%、出现先前未发现的新的室性心动过速或室性心动过速心跳次数增加10倍。3项试验在人口统计学、对奎尼丁治疗的反应或对奎尼丁的副作用方面没有差异。360例患者中有6例（2%）出现致心律失常反应，这些患者均无血流动力学症状，无需住院治疗，也未因致心律失常事件死亡。因此，对于符合本文所述纳入标准的门诊患者，可以安全地开始使用奎尼丁治疗。
