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Hydroquinidine is a class Ia antiarrhythmic agent and a d-rotatory alkaloid derived from cinchona bark. It is closely related to quinidine but differs by having two additional hydrogen atoms in its molecule. Hydroquinidine acts primarily by blocking the fast inward sodium current (INa) in cardiac cells, leading to increased action potential duration and prolonged QT interval. Its main clinical use is for the maintenance of normal sinus rhythm and treatment or prevention of certain types of cardiac arrhythmias, including those associated with Brugada syndrome. Hydroquinidine has also been used as an antimalarial agent. The drug is not approved by the FDA but is marketed in several countries under various brand names[1][2][3][8].
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