title: Efficacy and safety of the additional bepridil treatment in patients with atrial fibrillation refractory to class I antiarrhythmic drugs.
abstract: BACKGROUND
  Bepridil has multiple ion-channel blocking effects and is expected to be useful for managing atrial fibrillation (AF). The purpose of this study was to clarify the efficacy and safety of additional treatment with bepridil in patients with AF who had been treated with class I antiarrhythmic drugs (AADs).
  
  
  RESULTS
  Bepridil (50-200 mg/day) was given to 76 patients with either paroxysmal (n=49) or persistent AF (n=27). All patients had been treated with class I AADs (1.9+/-0.9 drugs/patient) that failed to control the AF. With the addition of bepridil, the frequency of symptomatic AF episodes decreased to less than 10% in 38 (78%) patients with paroxysmal AF, and sinus rhythm was restored within 3 months and maintained during the follow-up in 20 (74%) patients with persistent AF. Efficacy was usually obtained with a small to moderate dose (50-150 mg/day) of bepridil. During a mean follow-up period of 27+/-22 months, no potential complications occurred in any of the patients.
  
  
  CONCLUSIONS
  The addition of bepridil to class I AADs is effective and safe for AF, but careful observation using periodic ECG recordings is essential for avoiding torsades de pointes caused by QT prolongation.
authors.affiliation: Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, and Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Miyaji
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tada
authors.forename: Kengo
authors.initials: K
authors.lastname: Fukushima Kusano
authors.forename: Tohru
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kaseno
authors.forename: Shigeki
authors.initials: S
authors.lastname: Hiramatsu
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Tadokoro
authors.forename: Shigeto
authors.initials: S
authors.lastname: Naito
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Shigeru
authors.initials: S
authors.lastname: Oshima
authors.forename: Koichi
authors.initials: K
authors.lastname: Taniguchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Ohe
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D015764:Bepridil / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008133:Long QT Syndrome / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016879:Salvage Therapy / Q000379:methods; D016171:Torsades de Pointes / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D015764:Bepridil