Document Detail


Bepridil prevents paroxysmal atrial fibrillation by a class III antiarrhythmic drug effect.
MedLine Citation:
PMID:  12687836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: [corrected] Bepridil, a multiple ion-channel blocker, has been reported to prevent paroxysmal atrial fibrillation (PAF). The f-f interval of PAF during treatment with bepridil versus class Ic antiarrhythmic drugs was compared. METHODS: Fifty-two patients with PAF were randomized to bepridil, 200 mg/day (n = 14) versus flecainide, 100 to 200 mg/day (n = 15) or pilsicainide, 75 to 150 mg/day (n = 23). The drug was considered effective when symptomatic episodes of PAF were decreased to < 50% during a follow-up of 2 to 6 months. The f-f interval was measured in 12-lead ECGs of initial PAF episodes. RESULTS: Bepridil and Ic were effective in 10 of 14 (71.4%) and 24 of 38 patients (63.2%), respectively (ns). In the Ic group, the f-f interval was longer in successfully (114 +/- 48 ms) than in unsuccessfully (68 +/- 25 ms) treated patients (P = 0.002). In the bepridil group, the f-f interval was shorter in successfully (84 +/- 27 ms) than unsuccessfully (155 +/- 68 ms) treated patients (P = 0.015). When comparing unsuccessfully treated patients, the f-f interval in the bepridil group was significantly longer than in the Ic group (P = 0.007). CONCLUSIONS: Bepridil was as effective as Ic drugs in the prevention of PAF. Because it was more effective in smaller (functional) than larger (anatomical) reentrant circuits, the effect of bepridil was considered to be mainly attributable to a class III antiarrhythmic action.
Authors:
Toru Yoshida; Shinichi Niwano; Kimiatsu Inuo; Junko Saito; Jisho Kojima; Kazuko Ikeda-Murakami; Hideyuki Hara; Tohru Izumi
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-04-11     Completed Date:  2003-07-03     Revised Date:  2008-08-05    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  314-7     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Kitasato University School of Medicine, 1-15 Kitasato 1 Sagamihara, 228-8555 Japan. yoshidat@med.kitasato-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / diagnosis,  prevention & control*
Bepridil / therapeutic use*
Electrocardiography
Female
Flecainide / therapeutic use
Humans
Lidocaine / analogs & derivatives*,  therapeutic use
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 137-58-6/Lidocaine; 54143-55-4/Flecainide; 64706-54-3/Bepridil; 88069-49-2/pilsicainide

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