Key result
Verapamil prevented occlusion ventricular fibrillation but not reperfusion VF (13.3% vs 33% in control), whereas bepridil reduced reperfusion VF (0%) but was arrhythmogenic during ischemia.
Why the study?
Does verapamil or bepridil prevent occlusion and reperfusion ventricular arrhythmias in a canine model of myocardial ischemia?
Does verapamil or bepridil prevent occlusion and reperfusion ventricular arrhythmias in a canine model of myocardial ischemia?
Absolute Event Rate: 13.3% vs 33%
In a canine model, verapamil effectively prevents occlusion-induced but not reperfusion-induced ventricular fibrillation, whereas bepridil is arrhythmogenic during ischemia but prevents reperfusion ventricular fibrillation.
Differential calcium blocker effects on ischemic VF in canines; hypothesis-generating and should not inform clinical practice.
The effects of verapamil and bepridil on occlusion and reperfusion ventricular arrhythmias including ventricular fibrillation (VF) were studied in a canine model. The control group consisted of 27 dogs. 30 dogs received intravenous verapamil (0.2 mg/kg/3 min followed by a continuous infusion of 0.01 mg/kg/min for 15 min). 18 dogs received bepridil (0.5 mg/kg/min for 10 min). The left anterior descending coronary artery was occluded in one step 8 min after the commencement of verapamil administration and 5 min after the termination of bepridil infusion. The incidence of ventricular arrhythmias during the occlusion period was 14 (VF, 5/14), 13 (VF, 0/13) and 14 (VF, 9/14) in the control, verapamil and bepridil groups, respectively. The frequencies of reperfusion VF were 8/24 (33%), 4/30 (13.3%) and 0/13 (0%), respectively. It was concluded that (a) verapamil effectively prevents occlusion but not reperfusion VF and (b) bepridil has an arrhythmogenic effect in the ischemic canine heart but reduces the incidence of reperfusion VF.
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Pelleg et al. (2008) studied occlusion and reperfusion ventricular arrhythmias (n=75). Verapamil and Bepridil vs. Control was evaluated on reperfusion ventricular fibrillation. Verapamil prevented occlusion ventricular fibrillation but not reperfusion VF (13.3% vs 33% in control), whereas bepridil reduced reperfusion VF (0%) but was arrhythmogenic during ischemia.
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