[Oral and intravenous bepridil in the treatment of recurrent sustained ventricular tachycardias. Electropharmacological study].

The antiarrhythmic properties of bepridil on ventricular tachycardia (VT) termination and prevention were studied in 16 patients using programmed electrical stimulation techniques. All patients were admitted for documented sustained VT resistant to 3.5 +/- 2.4 antiarrhythmic agents. Intravenous bepridil (2 mg/kg) successfully terminated 4 out of 8 and prevented 3 out of 8 patients with hemodynamically well tolerated sustained VT. Oral bepridil (800 mg day 500-600 mg the following days) prevented successfully pacing-induced VT in 7 patients (43.7 p. cent) and a partial result was obtained in additional 3 (18.7 p. cent). In 6 patients bepridil failed to prevent pacing-induced VT including 2 patients with a shorter cycle length on bepridil (classified as aggravation). Tachycardia cycle length lengthened in the remaining 4 a mean of 11 +/- 12 p. cent. One of the 7 patients with a good result presented on bepridil evidence of sinus node dysfunction. The remaining 6 underwent long-term therapy (600 mg/24 h). During a mean follow up of 19 +/- 4 months, 4 patients are well controlled, 1 presented a side-effect (paralytic ileus) and 1 a recurrence. This study emphasizes the antiarrhythmic properties of bepridil at the ventricular level and provides evidence of its usefulness in patients with recurrent sustained VT.