What question did this study set out to answer?

To compare the clinical and electrophysiological effects of bepridil and amiodarone in patients with drug-refractory, established atrial fibrillation.

October 1, 1987HeartOpen Access

A comparison of bepridil with amiodarone in the treatment of established atrial fibrillation.

View Full Paper

Ask AI

Bookmark

Why the study?

Does bepridil improve conversion to sinus rhythm compared to amiodarone in patients with established, refractory atrial fibrillation?

Key Points

To compare the clinical and electrophysiological effects of bepridil and amiodarone in patients with drug-refractory, established atrial fibrillation.
Studied 14 patients with established atrial fibrillation lasting longer than three months that was refractory to treatment.
Administered bepridil (200–600 mg/day) for three weeks, followed sequentially by amiodarone (100–400 mg/day) for two to three months.
Bepridil converted 9 of 14 patients to sinus rhythm compared to 4 of 10 patients with amiodarone, while both drugs controlled ventricular rate equally well at rest and during exercise.
Bepridil caused ventricular arrhythmias in 8 of 14 patients in association with QTc interval prolongation, including two cases of torsade de pointes (one degenerating into fatal ventricular fibrillation), whereas amiodarone caused zero ventricular arrhythmias.

Structured PICO

Does bepridil improve conversion to sinus rhythm compared to amiodarone in patients with established, refractory atrial fibrillation?

Population

14 patients with established atrial fibrillation (longer than three months) that was refractory to treatment

Intervention

Bepridil 200-600 mg/day for three weeks

Comparator

Amiodarone 100-400 mg/day for two to three months (administered sequentially after bepridil)

Outcome

Conversion of fibrillation to sinus rhythmsurrogate

While bepridil is effective at converting refractory atrial fibrillation to sinus rhythm, its severe arrhythmogenic effects, including torsade de pointes and fatal ventricular fibrillation, make it unsuitable for clinical use.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Bepridil's arrhythmia risk warrants caution in refractory AF; hypothesis-generating and should not change practice.

Cite This Study

Perelman et al. (1987) studied this question.

synapsesocial.com/papers/6a8384a1df262e78b0721338 https://doi.org/10.1136/hrt.58.4.339

Topics

Persistent AF management Atrial fibrillation Anticoagulation in AF AF ablation outcomes

View Full Paper

Ask AI

Bookmark

A comparison of bepridil with amiodarone in the treatment of established atrial fibrillation.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

A comparison of bepridil with amiodarone in the treatment of established atrial fibrillation.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider