title: Use of bepridil in combination with Ic antiarrhythmic agent in converting persistent atrial fibrillation to sinus rhythm.
abstract: BACKGROUND
  It has been reported that bepridil is as good as amiodarone in converting persistent atrial fibrillation (AF) to sinus rhythm (SR). The conversion effect of bepridil alone is not always satisfactory, however. The efficacy of pharmacological cardioversion by the combination of bepridil and a class Ic antiarrhythmic drug for persistent AF is studied.
  
  
  RESULTS
  The participants comprised 37 consecutive patients in whom pharmacological cardioversion was conducted to treat persistent AF (duration 22.5+/-29.6 months). Each patient first received a class Ia or Ic antiarrhythmic drug, then bepridil alone, then a combined therapy of bepridil at 200 mg/day with a class Ic antiarrhythmic drug at a routine dose. Unaccompanied use of any of the antiarrhythmic drugs achieved pharmacological cardioversion in 14 (38%) of the 37 patients (single therapy group), whereas SR was restored by combination of bepridil and a class Ic antiarrhythmic drug in 22 (combined therapy group) of the remaining 23 patients. The duration of AF was significantly longer in the combined therapy group than in the single therapy group (28.3+/-31.0 vs 7.3+/-4.1 months).
  
  
  CONCLUSIONS
  Combined therapy of bepridil and a class Ic antiarrhythmic drug is efficient for pharmacological cardioversion of refractory long-lasting persistent AF.
authors.affiliation: Department of Cardiology, Nihon University Surugadai Hospital, Nihon University School of Medicine, Tokyo, Japan. imai@med.nihon-u.ac.jp
authors.forename: Shinobu
authors.initials: S
authors.lastname: Imai
authors.forename: Fumio
authors.initials: F
authors.lastname: Saito
authors.forename: Hidehito
authors.initials: H
authors.lastname: Takase
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Enomoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aoyama
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamaji
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.forename: Toshio
authors.initials: T
authors.lastname: Kushiro
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirayama
mesh_terms: D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D009320:Atrial Natriuretic Factor / Q000097:blood; D015764:Bepridil / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D005424:Flecainide / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007093:Imidazoles / Q000008:administration & dosage; D008012:Lidocaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012849:Sinoatrial Node; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; D020097:Natriuretic Peptide, Brain; D015764:Bepridil; D009320:Atrial Natriuretic Factor; D008012:Lidocaine; C042288:pilsicainide; D005424:Flecainide; C032151:cifenline