Use of bepridil in combination with Ic antiarrhythmic agent in converting persistent atrial fibrillation to sinus rhythm.
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.
Imai
Shinobu
S
Department of Cardiology, Nihon University Surugadai Hospital, Nihon University School of Medicine, Tokyo, Japan. imai@med.nihon-u.ac.jp
Saito
Fumio
F
Takase
Hidehito
H
Enomoto
Mitsunobu
M
Aoyama
Hiroshi
H
Yamaji
Satoshi
S
Yokoyama
Katsuaki
K
Yagi
Hiroshi
H
Kushiro
Toshio
T
Hirayama
Atsushi
A
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
D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; D020097:Natriuretic Peptide, Brain; D015764:Bepridil; D009320:Atrial Natriuretic Factor; D008012:Lidocaine; C042288:pilsicainide; D005424:Flecainide; C032151:cifenline