Miyaji Kohei, Tada Hiroshi, Fukushima Kusano Kengo, Hashimoto Tohru, Kaseno Kenichi, Hiramatsu Shigeki, Tadokoro Kazuyoshi, Naito Shigeto, Nakamura Kazufumi, Oshima Shigeru, Taniguchi Koichi, Ohe Tohru
Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, and Department of Cardiovascular Medicine, Okayama University Graduated School of Medicine, Density and Pharmaceutical Science, Japan.
Circ J. 2007 Aug;71(8):1250-7. doi: 10.1253/circj.71.1250.
Bepridil has multiple ion-channel blocking effects and is expected to be useful for managing atrial fibrillation (AF). The purpose of this study was to clarify the efficacy and safety of additional treatment with bepridil in patients with AF who had been treated with class I antiarrhythmic drugs (AADs).
Bepridil (50-200 mg/day) was given to 76 patients with either paroxysmal (n=49) or persistent AF (n=27). All patients had been treated with class I AADs (1.9+/-0.9 drugs/patient) that failed to control the AF. With the addition of bepridil, the frequency of symptomatic AF episodes decreased to less than 10% in 38 (78%) patients with paroxysmal AF, and sinus rhythm was restored within 3 months and maintained during the follow-up in 20 (74%) patients with persistent AF. Efficacy was usually obtained with a small to moderate dose (50-150 mg/day) of bepridil. During a mean follow-up period of 27+/-22 months, no potential complications occurred in any of the patients.
The addition of bepridil to class I AADs is effective and safe for AF, but careful observation using periodic ECG recordings is essential for avoiding torsades de pointes caused by QT prolongation.
苄普地尔具有多种离子通道阻滞作用，有望用于治疗心房颤动（AF）。本研究的目的是阐明在已接受I类抗心律失常药物（AADs）治疗的AF患者中加用苄普地尔的疗效和安全性。
对76例阵发性（n = 49）或持续性AF（n = 27）患者给予苄普地尔（50 - 200 mg/天）。所有患者均接受过I类AADs治疗（1.9±0.9种药物/患者），但未能控制AF。加用苄普地尔后，38例（78%）阵发性AF患者的症状性AF发作频率降至10%以下，20例（74%）持续性AF患者在3个月内恢复窦性心律并在随访期间维持。通常使用小至中等剂量（50 - 150 mg/天）的苄普地尔即可获得疗效。在平均27±22个月的随访期内，所有患者均未发生潜在并发症。
在I类AADs基础上加用苄普地尔治疗AF是有效且安全的，但为避免QT延长引起的尖端扭转型室速，定期进行心电图记录的仔细观察至关重要。
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