The Relationship between the Plasma Concentration of Bepridil and Its Efficacy in the Treatment of Atrial Fibrillation in Japanese Patients

Class IV Antiarrhythmic Agents: New Compounds Using an Old Strategy

“…AF was usually more sensitive to bepridil and a correlation was found between the efficacy of bepridil in AF and its plasma concentration measured just before the intake of the next oral dose. The target value to obtain clinical benefit was approximately 300 ng/ml [376]. 100-200 mg/day bepridil successfully converted AF to SR in 58 % of the patients within 6 month (2.1 in average) and maintained that for 18 months in 81 % of these patients [377].…”

“…) proved to possess antiarrhythmic properties using the epinephrine-, digitalis-and twostage coronary ligation-induced canine ventricular arrhythmia models as intravenous administration of AP-792 (0.3 or 1.0 mg/kg) effectively suppressed each of the ventricular arrhythmias and its antiarrhythmic action was slow in onset and long-lasting [390]. [193] Mibefradil / applied as co-medication caused TdP [347] Bepridil / 200-600 mg/day for 3 weeks in persistent AF patients VT, prolongation of QTc interval and TdP was observed [134] Bepridil / 200-600 mg/day for 3 weeks in patients with persistent AF, induced VT, prolongation of QTc interval and TdP more often compared to amiodarone [134] Bepridil / 100-200 mg/day induced QT prolongation, bradycardia, TdP usually triggered by hypokalemia, sudden decrease in HR in patients with AF or AFL [386] Bepridil / plasma level of approximately 300 ng/ml suppressed AF [376] Bepridil / 100-200 mg/day successfully converted AF to SR in about half of the patients [377] [378] Bepridil / 150 mg/day for 2 weeks followed by 100 or 200 mg/day converted AF to SR in shorter time and maintained SR for a longer period compared to amiodarone [380] Bepridil / applied as co-medication with various antiarrhythmic drugs prevented paroxysmal AF, converted AF to SR in persistent AF [381] [382] [383] Bepridil / a single dose of 800 mg followed by 500-600 mg prevented VT initiation in nonresponding VT patients [369] Bepridil / 2 mg/kg intravenously terminated AV reentrant tachycardia in a third of patients [232] Bepridil / 900 mg/day prevented the induction of sustained VT in 50 % of patients [372] Bepridil / mean dose of 156 mg/day suppressed ventricular tachyarrhythmias and decreased the frequency of ventricular tachyarrhythmia recurrences in 30 % of the patients [373] Bepridil / 200 mg/day reduced the frequency of VF episodes in idiopathic VF [374] Bepridil / 900 mg for 2 days followed by 400 mg/day moderate antiarrhythmic efficacy in patients with ventricular arrhythmias…”