ROLE OF COMBINED TREATMENT OF BEPRIDIL INPATIENTS WITH IMPLANTABLE CARDIOVERTERDEFIBRILLATORS.

摘要

Objective: To avoid ICD discharges for ventricular tachyarrhythmias (VTA), combined treatment with antiarrhythmic agents is sometimes needed. For VTA refractory to antiarrhythmic drugs including amiodarone and sotalol, bepridil, a multi ion-channel blocker may be a second choice drug, but its efficacy has not been well identified. Patients and methods: The present study included 11 patients (4 females, mean age 61+-17 years) having VTA, which was associated with structural heart disease and refractory to amiodarone and/or sotalol. Bepridil was administered at a mean dose of 145+-50 mg and followed up. Results: Bepridil prolonged QT interval (from 440+-43ms to 475+-49ms), while it did not change heart rate (from 60+-9bpm to 56+-7bpm) or QRS interval (from 132+-28ms to 139+-28ms). During a follow up of 26+-37 months, bepridil suppressed recurrences of VTA in 6 patients (55%). Although VTA recurred in other 5 patients, bepridil decreased the frequency of VTA in 3, and suppressed the electrical storm in one. The interval to the first VTA recurrence was 13+-23 months. No serious adverse effect including torsade de pointes was observed in any patient. Conclusions: Bepridil seemed to be useful to suppress VTA recurrences in some patients with ICD when amiodarone and/or sotalol failed to control VTA.