Sotalol Monitoring — EECC MCQ

Correct answer: A — Quinidine

Quinidine can suppress ventricular arrhythmia in selected patients with Brugada syndrome, including recurrent ICD shocks or electrical storm, by reducing the transient outward potassium current. Treatment requires specialist supervision because of QT prolongation, gastrointestinal effects and proarrhythmia. It does not replace an ICD when secondary-prevention criteria are met. Apply this conclusion only to the clinical circumstances stated, with appropriate specialist review, contraindication checks, shared decision-making and follow-up. Reassess if the physiology, treatment response or competing risk changes. The competing options would require a different haemodynamic profile, diagnosis, procedural indication or risk balance from the one described here.

Reference: 2022 ESC Guidelines for ventricular arrhythmias and sudden cardiac death. https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/ventricular-arrhythmias-and-the-prevention-of-sudden-cardiac-death/