Theory and practice of present clinical use of Quinidine in the management of cardiac arrhythmias.

At the beginning of the last century, quinidine had been shown to be highly effective in the management of atrial fibrillation and soon after, of ventricular arrhythmias. At the end of the same century, quinidine was quickly abandoned, and its manufacturing ceased, resulting in limited accessibility across numerous countries. Paradoxically, this decline in use occurred alongside accumulating evidence supporting quinidine's therapeutic benefit in managing rare, life-threatening ventricular arrhythmias occurring in patients with no organic heart disease (Idiopathic ventricular fibrillation, Brugada syndrome, Early repolarization syndrome, Short QT syndrome, Multifocal ectopic Purkinje-related premature contractions), as well as in those with organic heart disease involving the Purkinje network (acute myocardial infarction and hypertrophic cardiomyopathy). The present review will extensively deal with all these topics.