title: Bepridil for drug-refractory ventricular tachyarrhythmias.
abstract: OBJECTIVE
  To avoid frequent discharges of implantable cardioverter defibrillators, antiarrhythmic drugs may be needed in some patients with ventricular tachyarrhythmias. For ventricular tachyarrhythmias refractory to conventional antiarrhythmic drugs, we evaluated the efficacy of bepridil, a multiple ion-channel blocker.
  
  
  RESULTS
  Sixteen patients with structural heart disease and ventricular tachyarrhythmias refractory to multiple antiarrhythmic drugs (4.1+/-1.6 drugs including class III drugs) were enrolled. Bepridil was prescribed at a mean dose of 156+/-40 mg/day. Bepridil prolonged the QT/QTc interval without affecting heart rate or the QRS duration. During a mean follow-up of 52+/-44 months, bepridil completely suppressed ventricular tachyarrhythmias in 6 of the 16 patients (38%) and the drug decreased the frequency of ventricular tachyarrhythmia recurrences by >75% in 3 of the other 10 patients. The markers of complete suppression of ventricular tachyarrhythmias during bepridil treatment included a smaller number of VT morphologies, a better NYHA functional class, and a greater drug-induced prolongation of the QT/QTc interval. The result of electrophysiologic study-guided evaluation of bepridil was closely associated with the clinical efficacy of bepridil in 7 of 8 patients.
  
  
  CONCLUSIONS
  Bepridil appears to be useful to suppress drug-refractory ventricular tachyarrhythmia recurrence.
authors.affiliation: The Division of Cardiology and School of Health Sciences, Niigata. izumi2064-web@yahoo.co.jp
authors.forename: Daisuke
authors.initials: D
authors.lastname: Izumi
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Washizuka
authors.forename: Kazuki
authors.initials: K
authors.lastname: Okamura
authors.forename: Satoru
authors.initials: S
authors.lastname: Komura
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furushima
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D015764:Bepridil / Q000627:therapeutic use*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D055502:Secondary Prevention; D017180:Tachycardia, Ventricular / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D015764:Bepridil