Clinical Outcome in Patients With Paroxysmal or Persistent Atrial Fibrillation Receiving Bepridil

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• 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 800ng/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. (Circ J 2011; 75: 1334-1342)

• 2011-05-25

著者

• Hagiwara Nobuhisa

  Department Of Cardiology Tokyo Women's Medical University

• Shiga Tsuyoshi

  筑波大学 人間総合科学研究科循環器内科

• Seki Toshiro

  Department Of Medicine Institute Of Clinical Endocrinology Tokyo Women's Medical University

• Shoda Morio

  Department Of Cardiology Tokyo Women's Medical University

• Satoh Takahiro

  東京女子医科大学 循環器内科学

• Hagiwara Nobuhisa

  Cardiology Tokyo Women's Medical University

• Shiga Tsuyoshi

  Department Of Cardiology Tokyo Wemen's Medical University

• Shoda Morio

  Division Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University

• Shoda Morio

  Department Of Cardiology The Cardiovascular Center Of Sendai

• Hagiwara Nobuhisa

  Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical University

• Shiga Tsuyoshi

  Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University

• Suzuki Atsushi

  Department Of Animal Husbandry Faculty Of Agriculture Tohoku University

• Hagiwara Nobuhisa

  Departments Of Internal Medicine

• Sumiyoshi Tetsuya

  Department Of Cardiovascular Surgery Japanese Red Cross Kumamoto Hospital

• Naganuma Miyoko

  Department Of Cardiology Institute Of Geriatrics Tokyo Women's Medical University

• Hosaka Fumitaka

  Department Of Cardiology The Heart Institute Of Japan Tokyo Women's Medical University

• Hosaka Fumitaka

  Department Of Cardiology Kanto Medical Center Ntt Ec

• Sumiyoshi Tetsuya

  Tokyo Women's Medical College

• Syoda Morio

  Department Of Cardiology Iwate Medical University

• Shiga Tsuyoshi

  Dep. Of Cardiology Sakakibara Heart Inst. Japan Res. Promotion Soc. For Cardiovascular Diseases

• Naganuma Miyoko

  The Center For Clinical Research Tokyo Women's Medical University

• Seki Toshiro

  Department Of Cardiology Tokyo Women's Medical University

• Suzuki Atsushi

  Department Of Cardiology Tokyo Women's Medical University

• Syoda Morio

  Tokyo Women's Medical University

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