Continuous intravenous quinidine infusion for the treatment of atrial fibrillation or flutter: A case series

Background The purpose of the study was to evaluate a continuous intravenous quinidine infusion (CIQI) for the treatment of cardiac arrhythmias in critically ill patients. Methods and Results A 2-year retrospective review was conducted in adult patients receiving a CIQI for cardiac arrhythmias. Patient demographics, baseline laboratory values, indication for quinidine, dose, duration of therapy, efficacy, adverse events, and serum concentration were among the collected data. All patients were critically ill and receiving quinidine for the treatment of atrial arrhythmias. Quinidine was effective in 14 (61%) of the 23 enrolled patients. Ninety-one percent of the patients received the CIQI after surgery. A total of 8 (35%) patients died. Four (17%) patients had hypotension possibly attributed to the quinidine. Conclusions A continuous intravenous infusion of quinidine gluconate may be effective in patients in whom other agents are contraindicated or have failed. However, as with all antiarrhythmic agents, risks of therapy must be carefully considered. (Am Heart J 2000;139:114-21.)