Evaluation of the Effect of Bepridil on Paroxysmal Atrial Fibrillation. Relationship Between Efficacy and the f-f Interval in Surface ECG Recordings.

Clinical Evaluation of Adverse Effects During Bepridil Administration for Atrial Fibrillation and Flutter

“…[1][2][3][4] Bpd was recently reported as effective for AF and AFL. 5,[9][10][11][12] It has also multi-ion channel blocking effects similar to amiodarone, but fewer extra-cardiac adverse effects. [5][6][7][8][9][10][11][12] However, Tdp, which is one of the most serious adverse effects, has been reported, especially in elderly patients and patients with hypokalemia, a history of ventricular fibrillation, or preexisting QTc prolongation over 0.47.…”

“…[5][6][7][8][9][10][11][12] Although Bpd shows fewer serious extra-cardiac adverse effects than amiodarone, QT prolongation and torsade de pointes (Tdp) have been reported as major concerns. 13 In this study, we evaluated the adverse effects of Bpd, particularly the clinical background of patients with QT prolongation and Tdp.…”

Conversion and Maintenance of Sinus Rhythm by Bepridil in Patients With Persistent Atrial Fibrillation

“…11 Yoshida et al compared the efficacies of class Ic drugs and bepridil for preventing paroxysmal AF, and observed that the main effect of bepridil was a class III anti-arrhythmic action because of its effectiveness on paroxysmal AF with relatively short f-f intervals (small excitable-gap). 6,7 Fujiki et al used spectral analysis to compare the interval of the fibrillation cycle length (FCL) before and after bepridil and they noted a greater increase in FCL in responders and that the fibrillation waves became coarser before termination. 9 Although we did not analyze the fibrillation waves precisely in the current study, a representative ECG of the responders demonstrated that the fibrillatory waves were initially small and fine and then exhibited a coarse and large morphology prior to sinus restoration, consistent with the observations of Fujiki et al 9 Perelman et al reported a comparison of the effects of amiodarone and bepridil in 14 patients with AF.…”

“…[1][2][3][4] Therefore, bepridil is expected to have anti-arrhythmic effects, similar to those of class III drugs such as amiodarone, that would be useful for the management of atrial fibrillation (AF). [5][6][7] However, despite the clinical efficacy of bepridil, previous reports have emphasized the risk of torsade de pointes (TdP) because of QT prolongation from its relatively strong potassium channel blocking action. 8 There have only been a few studies of the clinical efficacy of bepridil, and those have particularly focused on the treatment of persistent AF.…”

Efficacy and Safety of the Additional Bepridil Treatment in Patients With Atrial Fibrillation Refractory to Class I Antiarrhythmic Drugs

“…[9][10][11][12] In particular, its potassiumchannel blocking action is relatively strong, and therefore bepridil is expected to be quite effective in the management of AF, similar to amiodarone. [13][14][15] In fact, several studies have demonstrated the efficacy and safety of bepridil or combination therapy using bepridil with aprindine for converting AF to SR. [14][15][16][17] However, few studies have attempted to determine the efficacy and safety of combined therapy with bepridil and other AADs. Furthermore, despite the clinical efficacy of bepridil, previous reports have emphasized the risk of torsades de pointes (TdP) because of QT prolongation related to its relatively strong potassiumchannel blocking action.…”