Drug-Induced Changes in Fibrillation Cycle Length and Organization Index Can Predict Chemical Cardioversion of Long-Lasting Atrial Fibrillation With Bepridil Alone or in Combination With Aprindine
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概要
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Background The aim of this study was to investigate whether drug-induced changes in fibrillation wave characteristics can predict pharmacological conversion of long lasting persistent atrial fibrillation (AF). Methods and Results The study group comprised 23 consecutive patients with AF lasting ≥1 month. Patients first received bepridil (200mg/day) for 2-4 weeks. When sinus rhythm was not restored with bepridil, oral aprindine (40 or 60 mg/day) was added to bepridil. Fast Fourier transform analysis of fibrillation waves using lead Vi was performed to calculate the fibrillation cycle length (FCL). The spectral areas were measured and the maximum area divided by the total area was termed the fibrillation organization index (FOI). Sinus rhythm was restored in 16 of 23 patients (70%); 8 of these 16 patients received only bepridil (Group I) and the other 8 responders received bepridil and aprindine (Group n). In Group I bepridil increased both FCL (p<0.001) and FOI (p<0.01) and terminated AF after 20±12 days. In Group H bepridil increased FCL (p<0.001), but did not change FOI. The addition of aprindine terminated AF in association with an increase in both FCL (p<0.005) and FOI (p<0.005) within 19±8 days. In the remaining 7 patients who did not have restoration of sinus rhythm, bepridil increased both FCL and FOI significantly, but less than in Group I, and the addition of aprindine did not further increase either of them. Chemical cardioversion of AF occurred in all patients with FCL ≥190ms and FOI ≥45% after drug administration. Conclusion Bepridil alone or in combination with aprindine converted long lasting persistent AF in association with an increase in both FCL and FOI. The combination of FCL and FOI after drug administration is helpful in predicting chemical cardioversion of persistent AF.
- 社団法人日本循環器学会の論文
- 2004-11-20
著者
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Tsuneda Takayuki
The Second Department of Internal Medicine, University of Toyama
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Inoue Hiroshi
The Second Department of Internal Medicine, University of Toyama
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Iwamoto Jotaro
The Second Department Of Internal Medicine Graduate School Of Medicine University Of Toyama
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Mizumaki Koichi
Second Department Of Internal Medicine University Of Toyama
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Fujiki Akira
Second Department Of Internal Medicine University Of Toyama
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Inoue Hiroki
Department Of Chemistry Faculty Of Science Kyushu University
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Fujiki Akira
The Second Department Of Internal Medicine
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Tsuneda Takayuki
The Second Department Of Internal Medicine Graduate School Of Medicine University Of Toyama
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MIZUMAKI Koichi
The Second Department of Inetranal Medicine, Toyama Medical and Pharmaceutical University
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Sakabe Masao
The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
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Sugao Masataka
The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
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Nishida Kunihiro
The Second Department of Internal Medicine, Graduate School of Medicine, University of Toyama
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Miwa Kunihisa
The Second Department Of Internal Medicine Toyama Medical And Pharmaceutical University
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Sakabe Masao
Second Department Of Internal Medicine University Of Toyama
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Nishida Kunihiro
The Second Department Of Internal Medicine Graduate School Of Medicine University Of Toyama
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Inoue Hiroshi
The Second Department Of Internal Medicine University Of Tokyo
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Inoue Hiroshi
The Second Department Of Internal Medicine
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