Journal of Arrhythmia (Jun 2012)

The use of serum bepridil concentration as a safe rhythm control strategy in patients with atrial tachyarrhythmias

  • Seiji Miura, MD,
  • Masataka Sumiyoshi, MD,
  • Hiroto Tsuchiya, MD,
  • Masaki Maruyama, MD,
  • I Seigen, MD,
  • Iwao Okai, MD,
  • Yoshiyuki Masaki, MD,
  • Shinya Okazaki, MD,
  • Kenji Inoue, MD,
  • Yasumasa Fujiwara, MD,
  • Kaoru Komatsu, MD,
  • Hidemori Hayashi, MD,
  • Gaku Sekita, MD,
  • Takashi Tokano, MD,
  • Yuji Nakazato, MD,
  • Hiroyuki Daida, MD

DOI
https://doi.org/10.1016/j.joa.2012.02.015
Journal volume & issue
Vol. 28, no. 3
pp. 187 – 191

Abstract

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The aim of this study was to evaluate the clinical significance of serum bepridil (Bep) concentration (SBC) for safely managing patients with atrial tachyarrhythmias (AT). Methods and results: SBC was measured in 37 patients with AT, including atrial fribrillation (AF) (31 cases), AF+atrial flutter (AFL) (4 cases), AFL (1 case), and atrial tachycardia (1 case). The patients were administrated Bep for more than 4 weeks at the same dose. SBC was positively correlated with Bep dose per kilogram of body weight (p=0.015), QT interval (p=0.019), and QTc (p=0.034). The patients were divided into 2 groups according to their SBC: the high-SBC (HSBC) group of 8 patients with an SBC≥500 ng/ml and a low-SBC (LSBC) group of 29 patients with an SBC0.5 were more prominent in the HSBC group (37.5% vs. 3.4%, p=0.026), and torsade de points (TdP) occurred in only one patient in the HSBC group. However, there were several patients with normal QT/QTc despite having high SBC. Conclusions: In patients treated with Bep, measurement of SBC is useful for preventing proarrhythmias.

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