THE SUPPRESSIVE EFFECT OF BEPRIDIL ON ATRIALFLUTTER ORGANIZED FROM PERSISTENT ATRIALFIBRILLATION DURING CLASS IC ANTIARRHYTHMICTHERAPY

摘要

Background: Combination therapy of class Ic antiarrhythmic drugs (AAD) and bepridil have been reported safe and effective on conversion from atrial fibrillation (AF) to sinus rhythm (SR). The aim of this study was to examine the efficacy of bepridil for atrial flutter (AFL), which developed from persistent AF while taking class Ic AAD. Methods and Results: In 16 of 64 patients with persistent AF, conversion from AF to AFL was observed after administration of class Ic AAD. Moreover, 15 of 16 patients were restored to SR 35+-5 days after taking bepridil and 12 of 15 patients maintained SR during follow-up of 24+-5 months. The 16 patients were divided into the two groups, depending on whether AF was changed to typical (GroupA:n=10) or atypical AFL (GroupB:n=6). In GroupA, AFL converted to SR in all patients compared to 5 of 6 patients in GroupB, and AF recurred spontaneously in 0% of GroupA vs. 60% of GroupB (p<0.01) during follow-up period. There were no significant differences between the two groups in patient characteristics.Conclusion: In the patients with persistent AF converting typical AFL during class Ic AAD, combination therapy with additional administration of bepridil may be useful for maintenance of SR.