Conversion and maintenance of sinus rhythm by bepridil in patients with persistent atrial fibrillation.
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.
Nakazato
Yuji
Y
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan. ynkzt@med.juntendo.ac.jp
Yasuda
Masayuki
M
Sasaki
Akitoshi
A
Iida
Youji
Y
Kawano
Yasunobu
Y
Nakazato
Kaoru
K
Tokano
Takashi
T
Mineda
Yoriaki
Y
Sumiyoshi
Masataka
M
Nakata
Yasuro
Y
Daida
Hiroyuki
H
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
D000889:Anti-Arrhythmia Agents; D015764:Bepridil