Document Detail


Clinical outcome in patients with paroxysmal or persistent atrial fibrillation receiving bepridil.
MedLine Citation:
PMID:  21483159     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: It is unknown whether bepridil improves cardiovascular events in atrial fibrillation (AF) patients, so this study evaluated the clinical outcome in paroxysmal or persistent AF patients receiving bepridil.
METHODS AND RESULTS: We conducted a cohort study of 284 consecutive patients who received bepridil for AF (25% female, 5913 years) with a median follow-up period of 17 months (4-157 months). A total of 135 (48%) patients had structural heart disease, and 231 patients (81%) had previously received class I or class III antiarrhythmic drugs. The cumulative rates for cardiovascular events were 2.4%, 8.1%, and 10.1% at 1, 3, and 5 years, respectively. The cumulative rates for a composite of mortality, cerebral infarction, systemic embolism, major bleeding and heart failure were 9.7%, 18.2%, and 29.6% at 1, 3, and 5 years, respectively. The probability of progression to permanent AF was 23.5% at 5 years. Sudden death occurred in a patient with a prior myocardial infarction who was taking 200mg daily, and torsade de pointes (Tdp) occurred in two patients without structural heart disease taking 200mg daily. Excessive corrected QT interval prolongation (>0.50s) was observed when plasma concentrations were higher than 800 ng/ml.
CONCLUSIONS: Bepridil might not improve the clinical outcome in refractory AF patients. Bepridil-related adverse events, including QT prolongation and Tdp, occurred in a dose- and concentration-dependent manner.
Authors:
Tsuyoshi Shiga; Atsushi Suzuki; Miyoko Naganuma; Fumitaka Hosaka; Morio Shoda; Nobuhisa Hagiwara
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-04-12
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-05-26     Completed Date:  2011-09-16     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1334-42     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. mshiga@hij.twmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / adverse effects,  pharmacokinetics,  therapeutic use*
Atrial Fibrillation / complications,  diagnosis,  drug therapy*,  mortality
Bepridil / adverse effects,  pharmacokinetics,  therapeutic use*
Cardiovascular Diseases / etiology,  mortality,  prevention & control*
Dose-Response Relationship, Drug
Electrocardiography
Female
Humans
Japan
Kaplan-Meier Estimate
Male
Middle Aged
Recurrence
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 64706-54-3/Bepridil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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