Key result
Bepridil converted persistent atrial fibrillation to sinus rhythm in 37.5% of patients at 100 mg/day and 69.0% at 200 mg/day, but carries a 1.1% risk of sudden cardiac death due to QT prolongation.
Why the study?
Does bepridil safely improve conversion to sinus rhythm in patients with persistent atrial fibrillation?
Does bepridil safely improve conversion to sinus rhythm in patients with persistent atrial fibrillation?
While bepridil is highly effective for pharmacological cardioversion of persistent AF, its significant risk of fatal proarrhythmia (TdP) requires strict monitoring and questions its role as a first-line therapy compared to catheter ablation.
wo therapeutic strategies exist for the treatment of persistent atrial fibrillation (AF): electrical (or pharmacological) cardioversion followed by antiarrhythmic drugs (rhythm control) or control of heart rate during AF (rate control). Both therapies are reported to be comparable in terms of mortality, whereas rhythm control may be preferable in terms of preserving the quality of life. 1 In the ACC/AHA/ESC 2006 Guidelines describing the treatment of recurrent persistent AF, 2 patients with symptoms favoring sinus rhythm should be treated with an antiarrhythmic drug before cardioversion, as shown in Figure
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Kenzo Hirao (2009) conducted an editorial in Persistent atrial fibrillation. Bepridil vs. Placebo was evaluated on Conversion success rate to sinus rhythm. Bepridil converted persistent atrial fibrillation to sinus rhythm in 37.5% of patients at 100 mg/day and 69.0% at 200 mg/day, but carries a 1.1% risk of sudden cardiac death due to QT prolongation.
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