心房細動治療に対するベプリジルの有効性と安全性の検討

概要

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Atrial fibrillation is the most clinically prevalent tachyarrhythmia. As cerebral embolism lowers quality of life and heart failure worsens prognosis, atrial fibrillation requires active management. Class I antiarrhythmics are initially used to prevent atrial fibrillation, but are ineffective in some cases. The efficacy of bepridil has been documented for atrial fibrillation resistant to class I antiarrhythmics, but optimal dose and administration methods remain unclear. We investigated the efficacy and safety of bepridil. This retrospective cohort study examined 243 patients who received oral bepridil at the Department of Cardiology, Tokyo Women's Medical University, from November 1, 2000 to August 31, 2006. Bepridil was considered clinically effective in 154 patients (63.4%). Cumulative rate of sinus rhythm maintenance and cumulative rate of permanent atrial fibrillation were more favorable than results for class I drugs and were comparable to amiodarone. Regarding adverse effects, 16 patients (6.6%) had QT interval prolongation and 2 patients (0.8%) had Torsades de pointes (TdP). Mean maintenance dose of bepridil was at 141 ± 46mg/day. If other antiarrhythmics are ineffective or contraindicated, bepridil help to prevent atrial fibrillation. Dose-dependency was also suggested for TdP; therefore, to prevent atrial fibrillation, QT interval must be carefully monitored and dose minimized when administering bepridil.
東京女子医科大学の論文