Nakazato Yuji, Yasuda Masayuki, Sasaki Akitoshi, Iida Youji, Kawano Yasunobu, Nakazato Kaoru, Tokano Takashi, Mineda Yoriaki, Sumiyoshi Masataka, Nakata Yasuro, Daida Hiroyuki
Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
Circ J. 2005 Jan;69(1):44-8. doi: 10.1253/circj.69.44.
Bepridil has multiple ion-channel blocking effects similar to amiodarone and is expected to have anti-arrhythmic effects that are useful for the management of atrial fibrillation (AF). The aim of this study was to clarify the conversion of persistent AF and maintenance of sinus rhythm (SR) by oral bepridil.
Oral bepridil was administered to 112 patients (83 males, 29 females; age: 59.0+/-10.8 years) with persistent AF lasting an average of 5 months. The conversion effects and maintenance of SR after pharmacological or direct current (DC) cardioversion, as well as the incidence of adverse complications, were evaluated. In 65 of 112 (58%) patients, SR was restored within 6 months (average: 2.1 months) following bepridil administration. DC cardioversion was carried out for 21 of the remaining 47 patients with unsuccessful pharmacological conversion, and all had restoration of SR. Eventually, of the 86 patients in total who were restored to SR by either bepridil or DC cardioversion, 70 (81%) patients maintained SR after a mean follow-up of 18 months. No serious adverse complications were observed, except for marked QT prolongation in 2 cases.
Bepridil showed favorable conversion effects in patients with persistent AF and was highly effective for maintaining SR after pharmacological or electrical cardioversion. However, careful follow-up is necessary for the prevention of torsade de pointes caused by QT prolongation.
苄普地尔具有与胺碘酮相似的多种离子通道阻滞作用，预计具有可用于心房颤动（AF）管理的抗心律失常作用。本研究的目的是阐明口服苄普地尔对持续性AF的转复及窦性心律（SR）的维持情况。
对112例持续性AF患者（男性83例，女性29例；年龄：59.0±10.8岁）口服苄普地尔，持续性AF平均持续5个月。评估了药物或直流电（DC）复律后SR的转复效果及维持情况，以及不良并发症的发生率。112例患者中有65例（58%）在服用苄普地尔6个月内（平均：2.1个月）恢复SR。对其余47例药物转复未成功的患者中的21例进行了DC复律，所有患者均恢复SR。最终，在通过苄普地尔或DC复律恢复SR的86例患者中，70例（81%）在平均随访18个月后维持SR。除2例出现明显QT延长外，未观察到严重不良并发症。
苄普地尔对持续性AF患者显示出良好的转复效果，对药物或电复律后维持SR非常有效。然而，为预防QT延长引起的尖端扭转型室速，需要进行仔细的随访。
