Document Detail


Combination therapy of renin angiotensin system inhibitors and bepridil is useful for maintaining sinus rhythm in patients with atrial fibrillation.
MedLine Citation:
PMID:  18186308     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The present study evaluated the effect of treatment renin angiotensin system inhibitors (RAS-I) for maintaining sinus rhythm after conversion from persistent atrial fibrillation. As the efficacy of RAS-I in atrial fibrillation is unclear, our study evaluated conversion to and maintenance of sinus rhythm by combination therapy with RAS-I and bepridil in patients in atrial fibrillation. METHODS: Bepridil was administered to 125 consecutive patients with paroxysmal and persistent atrial fibrillations. Two groups of patients were compared: The bepridil group was treated with bepridil alone, the RAS-I group with bepridil plus angiotensin II receptor blockers or angiotensin converting enzyme inhibitors. The primary end point was length of time to first recurrence of atrial fibrillation. RESULTS: Maintenance of sinus rhythm was achieved in 25 patients (45%) in the bepridil group and 44 patients (63%) in the RAS-I group (persistent and paroxysmal atrial fibrillations). The difference between the bepridil group and the RAS-I group was significant (p < 0.05). Maintenance of sinus rhythm was achieved in 9 of 25 patients (36%) in the bepridil group, and in 22 of 35 patients (62%) in the RAS-I group with persistent atrial fibrillation. The difference between the bepridil group and the RAS-I group was significant (p < 0.05). Bepridil plus RAS-I was particularly effective at preventing the recurrence of atrial fibrillation in patients with left ventricular dysfunction (left ventricular ejection fraction < 50%). CONCLUSIONS: Combination therapy with RAS-I and bepridil may be useful for maintenance of sinus rhythm.
Authors:
Mitsuharu Kawamura; Hiroyuki Ito; Tatsuya Onuki; Fumito Miyoshi; Yoshino Minoura; Taku Asano; Kaoru Tanno; Youichi Kobayashi
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of cardiology     Volume:  50     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2008-01-11     Completed Date:  2008-02-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  343-50     Citation Subset:  IM    
Affiliation:
The Third Department of Internal Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo, Japan. mitsu-0709@fiberbit.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiotensin-Converting Enzyme Inhibitors / administration & dosage
Anti-Arrhythmia Agents / administration & dosage*
Atrial Fibrillation / drug therapy*,  physiopathology
Bepridil / administration & dosage*
Drug Therapy, Combination
Female
Humans
Male
Receptors, Angiotensin / antagonists & inhibitors*
Ventricular Dysfunction, Left / drug therapy
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Anti-Arrhythmia Agents; 0/Receptors, Angiotensin; 64706-54-3/Bepridil

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