title: Conversion and maintenance of sinus rhythm by bepridil in patients with persistent atrial fibrillation.
abstract: BACKGROUND
  Bepridil has multiple ion-channel blocking effects similar to amiodarone and is expected to have anti-arrhythmic effects that are useful for the management of atrial fibrillation (AF). The aim of this study was to clarify the conversion of persistent AF and maintenance of sinus rhythm (SR) by oral bepridil.
  
  
  RESULTS
  Oral bepridil was administered to 112 patients (83 males, 29 females; age: 59.0+/-10.8 years) with persistent AF lasting an average of 5 months. The conversion effects and maintenance of SR after pharmacological or direct current (DC) cardioversion, as well as the incidence of adverse complications, were evaluated. In 65 of 112 (58%) patients, SR was restored within 6 months (average: 2.1 months) following bepridil administration. DC cardioversion was carried out for 21 of the remaining 47 patients with unsuccessful pharmacological conversion, and all had restoration of SR. Eventually, of the 86 patients in total who were restored to SR by either bepridil or DC cardioversion, 70 (81%) patients maintained SR after a mean follow-up of 18 months. No serious adverse complications were observed, except for marked QT prolongation in 2 cases.
  
  
  CONCLUSIONS
  Bepridil showed favorable conversion effects in patients with persistent AF and was highly effective for maintaining SR after pharmacological or electrical cardioversion. However, careful follow-up is necessary for the prevention of torsade de pointes caused by QT prolongation.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. ynkzt@med.juntendo.ac.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakazato
authors.forename: Masayuki
authors.initials: M
authors.lastname: Yasuda
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Sasaki
authors.forename: Youji
authors.initials: Y
authors.lastname: Iida
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Kawano
authors.forename: Kaoru
authors.initials: K
authors.lastname: Nakazato
authors.forename: Takashi
authors.initials: T
authors.lastname: Tokano
authors.forename: Yoriaki
authors.initials: Y
authors.lastname: Mineda
authors.forename: Masataka
authors.initials: M
authors.lastname: Sumiyoshi
authors.forename: Yasuro
authors.initials: Y
authors.lastname: Nakata
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D015764:Bepridil / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000889:Anti-Arrhythmia Agents; D015764:Bepridil