Non Invasive Electrophysiological Evaluation of Pilsicainide and Bepridil in Late Potential and T-Wave Variability in Patients with Proximal Atrial Fibrillation

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Background and Methods: There is little report about the influence of antiarrhythmic drug on the noninvasive electrophysiological indexes. We used the high-resolution ambulatory electrocardiogram to examine the late potential (LP) and T-wave Variability (TWV) under the administration of pilsicainide or bepridil in patients with isolated paroxysmal atrial fibrillation (PAF). Fifty-five PAF patients were classified into 3 groups: with non-antiarrhythmic group (PAF, n=18), Pilsicainide group (n=20), Bepridil group (n=17). Result: The worst values during 24 hours of FQRS, LAS, and RMS had significant differences in comparison with 4 groups. The positive LP ratios were 5% in Control, 20% in PAF, 54% in Pilsicainide, and 37% in Bepridil (p<0.05). There were no significant differences in TWV positive ratio. Heart rate was significantly decreased in Bepridil only. Conclusion: The positive ratio of LP was high in PAF patients compared to normal peoples. Pilsicainide effect was especially prominent in the prolongation of the ventricular depolarization time, whereas bepridil effect was slight. The exacerbation of the repolarization instability was not recognized by the both drugs. It will be necessary to examine the atrium LP analysis and autonomic function in the additional study.