Key result
Oral bepridil resulted in a significantly higher 14-day atrial fibrillation recurrence-free survival rate compared to aprindine (76% vs 49%, P=0.028) after cardiovascular surgery.
Why the study?
Does oral bepridil 100 mg/day prevent postoperative atrial fibrillation recurrence more effectively than oral aprindine 40 mg/day in patients who developed paroxysmal AF after cardiac and aortic surgery?
RCT (n=72)
Does oral bepridil 100 mg/day prevent postoperative atrial fibrillation recurrence more effectively than oral aprindine 40 mg/day in patients who developed paroxysmal AF after cardiac and aortic surgery?
Bepridil 100 mg/day is more effective than aprindine 40 mg/day for preventing the recurrence of postoperative atrial fibrillation after cardiac and aortic surgery.
Answers are grounded in this paper and cite their sources.
Bepridil was associated with lower early post-surgical AF recurrence; hypothesis-generating and requires randomized confirmation before practice change.
BACKGROUND: Approximately one-third of the patients undergoing cardiovascular surgery reportedly experience paroxysmal atrial fibrillation (AF) during the postoperative period. However, the usefulness of antiarrhythmic drugs for preventing postoperative AF recurrence in the Japanese population has not been extensively studied. METHODS: From a total of 118 patients who developed postoperative paroxysmal AF between April 2009 and March 2011, 72 patients (45 men, mean age 68±8 years) requiring treatment for postoperative AF due to symptoms lasting ≥30 min were enrolled to prospectively investigate the efficacy of oral bepridil (100 mg/day, n=37) or aprindine (40 mg/day, n=35). RESULT: The AF recurrence-free survival rates at 1, 3, 7, and 14 days were 100%, 94%, 57%, and 49%, respectively, in the aprindine group, and 100%, 97%, 86%, and 76%, respectively, in the bepridil group (P=0.028, aprindine vs. bepridil). CONCLUSION: Bepridil, at a fixed dose of 100 mg/day, was considered to be more effective than a routine dose of aprindine for the prevention of postoperative AF recurrence.
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Ozawa et al. (2015) conducted an RCT in Postoperative paroxysmal atrial fibrillation (n=72). Bepridil vs. Aprindine (40 mg/day) was evaluated on Atrial fibrillation recurrence-free survival rate at 14 days (p=0.028). Oral bepridil resulted in a significantly higher 14-day atrial fibrillation recurrence-free survival rate compared to aprindine (76% vs 49%, P=0.028) after cardiovascular surgery.
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