Use of bepridil in combination with Ic antiarrhythmic agent in converting persistent atrial fibrillation to sinus rhythm
Use of bepridil in combination with Ic antiarrhythmic agent in converting persistent atrial fibrillation to sinus rhythm
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DOI：
10.1253/circj.72.709
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发表时间：
2008-05-01
影响因子：
3.3
通讯作者：
Hirayama, Atsushi
中科院分区：
文献类型：
--
作者：
Imai, Shinobu;Saito, Fumio;Hirayama, Atsushi
背景：有报道称苄普地尔在转复持续性房颤（AF）为窦性心律（SR）方面与胺碘酮一样有效。然而，单独使用苄普地尔的转化效果并不总是令人满意的。药理复律的疗效由苄普地尔和Ic类抗心律失常药物的组合为持续性aflast.Methods和结果的参与者包括37个连续的患者，其中进行药理复律治疗持续性房颤（持续时间22.5 +/- 29.6个月）。每个患者首先接受Ia或Ic类抗肿瘤药物，然后单独使用苄普地尔，然后以200 mg/天的苄普地尔与常规剂量的Ic类抗肿瘤药物联合治疗。单独使用任何抗心律失常药物在37例患者中的14例（38%）（单一治疗组）中实现了药理学复律，而在其余23例患者中的22例（联合治疗组）中，苄普地尔和Ic类抗心律失常药物联合治疗恢复了SR。结论苄普地尔联合Ic类抗心律失常药对难治性持续性房颤的药物复律有效，且与单用药物相比，联合用药组房颤持续时间明显延长（28.3 ± 31.0 vs 7.3 ± 4.1个月）。
Background It has been reported that bepridil is as good as amiodarone in converting persistent atrial fibrillation (AF) to sinus rhythm (SR). The conversion effect of bepridil alone is not always satisfactory, however. The efficacy of pharmacological cardioversion by the combination of bepridil and a class Ic antiarrhythmic drug for persistent AF is studied.Methods and Results The participants comprised 37 consecutive patients in whom pharmacological cardioversion was conducted to treat persistent AF (duration 22.5 +/- 29.6 months). Each patient first received a class la or Ic antiarrhythmic drug, then bepridil alone, then a combined therapy of bepridil at 200mg/day with a class Ic antiarrhythmic drug at a routine dose. Unaccompanied use of any of the antiarrhythmic drugs achieved pharmacological cardioversion in 14 (38%) of the 37 patients (single therapy group), whereas SR was restored by combination of bepridil and a class Ic antiarrhythmic drug in 22 (combined therapy group) of the remaining 23 patients. The duration of AF was significantly longer in the combined therapy group than in the single therapy group (28.3 +/- 31.0 vs 7.3 +/- 4.1 months).Conclusion Combined therapy of bepridil and a class Ic antiarrhythmic drug is efficient for pharmacological cardioversion of refractory long-lasting persistent AF.