Evaluation of the Effect of Bepridil on Paroxysmal Atrial Fibrillation : Relationship Between Efficacy and the f-f Interval in Surface ECG Recordings

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• Bepridil, a multi-ion channel blocker, is effective for some types of cardiac arrhythmias, and so its effect on the paroxysmal atrial fibrillation (PAF) was evaluated in the present study, comparing it with class Ic antiarrhythmic drugs. The relationship between efficacy and the f-f interval in the surface ECG recording was also analyzed. Sixty-one symptomatic PAF patients were randomized to a bepridil group (200mg/day, n=23) or class Ic drug group (flecainide 100-200mg/day or pilsicainide 75-150mg/day, n=38). The drug was considered effective for PAF prevention when symptomatic episodes of PAF were decreased to less than 50% during the follow-up period of 2-6 months. The f-f interval in the surface 12-lead ECG trace was evaluated during a PAF episode. Both bepridil and the class Ic drugs were effectively prevented PAF (15/23 (65.2%) vs 24/38 (63.1%) patients, NS). In the class Ic drug group, the f-f interval was longer in the effective cases (114±48 ms) than in the non-effective cases (68±26ms, p=0.0002). In contrast, in the bepridil group the f-f interval was shorter in the effective cases (85±26 ms) than in the non-effective ones (152±45 ms, p=0.0005). When comparing the non-effective cases in the 2 groups, the bepridil group showed a significantly longer f-f interval than the class Ic drug group (p=0.0003). As a result of drug administration, the class Ic drugs prolonged the f-f interval from 78±33 ms to 128±46ms (p=0.0004) whereas bepridil showed no change (109±39ms vs 135±47ms). For clinical PAF prevention, the effect of bepridil matched that of class Ic antiarrhythmic drugs. Because bepridil was effective in PAF patients with relatively shorter f-f intervals without prolonging the f-f interval, bepridil is considered to work mainly as a class III antiarrhythmic drug.

• 社団法人日本循環器学会の論文
• 2002-12-20

著者

• Izumi Tohru

  Department Of Cardio-angiology Kitasato University School Of Medicine

• NIWANO Shinichi

  Department of Cardio-Angiology, Kitasato University School of Medicine

• Izumi Tohru

  北里大学 医学部循環器内科

• SAITO Junko

  Department of Obstetrics and Gynecology, Osaka University Medical School

• HARA Hideyuki

  Department of Precision Science and Technology, Graduate School of Engineering, University of Osaka

• Kojima Jisho

  Department of Cardio-angiology, Kitasato University School of Medicine

• Kojima Jisho

  北里大学 医学部循環器内科学

• Kojima Jisho

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Niwano Shinichi

  Department Of Cardio-angiology Kitasato University School Of Medicine

• Niwano Shinichi

  日本不整脈学会

• Inuo Kimiatsu

  Department of internal Medicine,Kitasato University School of Medicine

• Yoshida Toru

  Department of Internal Medicine, Kitasato University School of Medicine

• Ikeda-Murakami Kazuko

  Department of Internal Medicine, Kitasato University School of Medicine

• Ikeda Kazuko

  Department Of Internal Medicine Kitasato University School Of Medicine

• Miwano Shinichi

  北里大学

• Kojima Jisyo

  Department Of Internal Medicine Kitasato University School Of Medicine

• Inuo Kimiatsu

  北里大学 内科学

• Inuo Kimiatsu

  Department Of Internal Medicine Kitasato University School Of Medicine

• Yoshida Toru

  北里大学 医学部救命救急医学

• Saitou Junko

  Department Of Internal Medicine Kitasato University School Of Medicine

• Saito Junko

  Department Of Biology Faculty Of Education Yamanashi University

• Hara Hideyuki

  Department Of Internal Medicine

• Hara Hideyuki

  Department Of Internal Medicine Kitasato University School Of Medicine

• Niwano Shinichi

  北里大学 医学部循環器内科学

• Yoshida Toru

  Department Of Gastroenterology And Hepatology Kyoto University Graduate School Of Medicine

• Yoshida Toru

  Department Of Internal Medicine Cardiology Kitasato University School Of Medicine

• Niwano Shinichi

  Department Of Cardio-angiology Kitasato University

• Ikeda Kazuko

  Department Of Internal Medcine Kitasato University School Of Medicine

• Izumi Tohru

  Department Of Cardio-angiology Kitasato University School Of Medcine

• Hara Hideyuki

  北里大学 医学部循環器内科学

• Yoshida Toru

  Department Of Emergency And Critical Care Medicine St. Marianna University School Of Medicine

• Hara Hideyuki

  Department Of Electro Photo Optics Faculty Of Engineering Tokai University

• Izumi Tohru

  Department Of Internal Medicine And Cardiology And Gene Genetcs Kitasato University School Of Medici

• Kojima Jisho

  Department Of Internal Medicine Kitasato University School Of Medicine

• Izumi Tohru

  Department Of Angio-cardiology Kitasato University School Of Medicine

• NIWANO Shinichi

  Department of Cardio-andiology, Kitasato University School of Medicine

• Niwano Shinichi

  Department of Angio-Cardiology, Kitasato University School of Medicine

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