Effectiveness of amiodarone versus bepridil in achieving conversion to sinus rhythm in patients with persistent atrial fibrillation: a randomised trial
AimsPharmacological conversion to sinus rhythm is generally difficult to achieve, particularly in long-lasting persistent atrial fibrillation (AF). The purpose of this study is to compare the effectiveness of two agents, amiodarone and bepridil, in achieving conversion to sinus rhythm in patients wi...
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| Veröffentlicht in: | Heart (British Cardiac Society) 2012-07, Vol.98 (14), p.1067-1071 |
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| creator | Yamase, Miki Nakazato, Yuji Daida, Hiroyuki |
| description | AimsPharmacological conversion to sinus rhythm is generally difficult to achieve, particularly in long-lasting persistent atrial fibrillation (AF). The purpose of this study is to compare the effectiveness of two agents, amiodarone and bepridil, in achieving conversion to sinus rhythm in patients with persistent AF.Methods and resultsAmiodarone (A) or bepridil (B) was administered to 40 consecutive patients (36 male subjects, age 61 years) with persistent AF in a prospective, randomised, open label fashion. The pharmacological effects in bringing about conversion to sinus rhythm and subsequently maintaining sinus rhythm were evaluated. If sinus rhythm was not restored within 3 months, direct current (DC) cardioversion was performed. The incidence of adverse effects was also evaluated. Sinus rhythm was restored in seven (35%) of 20 patients in group A (average follow-up of 3.2 months) and in 17 (85%) of 20 in group B (average follow-up of 2.3 months) (p |
| doi_str_mv | 10.1136/heartjnl-2012-302017 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1022846803</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1022846803</sourcerecordid><originalsourceid>FETCH-LOGICAL-b443t-942c681a51405f073176abe1953bd7c45f6e055799c5aa633678e62b3a5b0c703</originalsourceid><addsrcrecordid>eNqNkUtv1DAUhSMEog_4BwhZQkhsQv2I7YQdDKUgVbDgIXbWjeMQD4k92M6U_hL-Lg6ZFokVq2v5fvfo6JyieETwc0KYOBsMhLR1Y0kxoSXDecg7xTGpRL18fb2b34zzUmAmj4qTGLcY46qpxf3iiFJRN5LQ4-LXed8bnezeOBMj8j2CyfoOgncG7U2Ic0St2QXb2RFZh0AP1uyt-4a0d8veeoeSR9G6TIbhOg3Twu0gWeNSRFc2DWi3gDHlDwQpWBhRb9tgxzFT3r1AgAK4zk82mg79AR4U93oYo3l4mKfF5zfnnzZvy8sPF-82Ly_LtqpYKpuKalET4KTCvMeSESmgNaThrO2krngvDOZcNo3mAIIxIWsjaMuAt1hLzE6LZ6vuLvgfs4lJZRPaZGfO-Dkqgimtc6SYZfTJP-jWz8Fld4rIGkvKJF-oaqV08DEG06sc3gThOkuppTh1U5xailNrcfns8UF8bifT3R7dNJWBpwcAooaxz4FpG_9yglCK8SJUrtyS98_bPYTvSsjsUL3_slG0udjQV_S1-pj5s5Vvp-3_Wf0NOCDDdQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1780723753</pqid></control><display><type>article</type><title>Effectiveness of amiodarone versus bepridil in achieving conversion to sinus rhythm in patients with persistent atrial fibrillation: a randomised trial</title><source>BMJ Journals Online Archive</source><source>MEDLINE</source><source>PubMed Central</source><creator>Yamase, Miki ; Nakazato, Yuji ; Daida, Hiroyuki</creator><creatorcontrib>Yamase, Miki ; Nakazato, Yuji ; Daida, Hiroyuki</creatorcontrib><description>AimsPharmacological conversion to sinus rhythm is generally difficult to achieve, particularly in long-lasting persistent atrial fibrillation (AF). The purpose of this study is to compare the effectiveness of two agents, amiodarone and bepridil, in achieving conversion to sinus rhythm in patients with persistent AF.Methods and resultsAmiodarone (A) or bepridil (B) was administered to 40 consecutive patients (36 male subjects, age 61 years) with persistent AF in a prospective, randomised, open label fashion. The pharmacological effects in bringing about conversion to sinus rhythm and subsequently maintaining sinus rhythm were evaluated. If sinus rhythm was not restored within 3 months, direct current (DC) cardioversion was performed. The incidence of adverse effects was also evaluated. Sinus rhythm was restored in seven (35%) of 20 patients in group A (average follow-up of 3.2 months) and in 17 (85%) of 20 in group B (average follow-up of 2.3 months) (p<0.05). After pharmacological or DC cardioversion, sinus rhythm could be maintained in 10 (50%) of 20 patients in group A (average follow-up of 14.7 months) and 15 (75%) of 20 patients in group B (average follow-up of 15.6 months). QT interval and QTc were significantly prolonged compare with the baseline values in group B, but no torsade de pointes was recognised in any of the patients. One patient in the group B developed interstitial pneumonia, but steroid therapy cured the condition.ConclusionsBepridil was superior to amiodarone in achieving sinus conversion and in maintaining sinus rhythm after cardioversion in patients with persistent AF. Even so, we must be watchful for potentially serious adverse complications when administering bepridil.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/heartjnl-2012-302017</identifier><identifier>PMID: 22689712</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>amiodarone ; Amiodarone - administration & dosage ; Anti-Arrhythmia Agents - administration & dosage ; arrhythmias ; atrial fibrillation ; Atrial Fibrillation - drug therapy ; Atrial Fibrillation - physiopathology ; bepridil ; Bepridil - administration & dosage ; Biological and medical sciences ; brugada ; Cardiac arrhythmia ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Cardioversion ; Dose-Response Relationship, Drug ; Drug dosages ; Electrocardiography ; Electrocardiography - drug effects ; Female ; Follow-Up Studies ; Heart ; Heart rate ; Heart Rate - drug effects ; Humans ; lipids ; Male ; Medical sciences ; Middle Aged ; Performance evaluation ; persistent atrial fibrillation ; Prospective Studies ; Sinuses ; Studies ; sudden cardiac death ; Time Factors ; torsade de pointes ; Treatment Outcome</subject><ispartof>Heart (British Cardiac Society), 2012-07, Vol.98 (14), p.1067-1071</ispartof><rights>2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>2015 INIST-CNRS</rights><rights>Copyright: 2012 (c) 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b443t-942c681a51405f073176abe1953bd7c45f6e055799c5aa633678e62b3a5b0c703</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://heart.bmj.com/content/98/14/1067.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://heart.bmj.com/content/98/14/1067.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3182,23551,27903,27904,77347,77378</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26122007$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22689712$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yamase, Miki</creatorcontrib><creatorcontrib>Nakazato, Yuji</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><title>Effectiveness of amiodarone versus bepridil in achieving conversion to sinus rhythm in patients with persistent atrial fibrillation: a randomised trial</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>AimsPharmacological conversion to sinus rhythm is generally difficult to achieve, particularly in long-lasting persistent atrial fibrillation (AF). The purpose of this study is to compare the effectiveness of two agents, amiodarone and bepridil, in achieving conversion to sinus rhythm in patients with persistent AF.Methods and resultsAmiodarone (A) or bepridil (B) was administered to 40 consecutive patients (36 male subjects, age 61 years) with persistent AF in a prospective, randomised, open label fashion. The pharmacological effects in bringing about conversion to sinus rhythm and subsequently maintaining sinus rhythm were evaluated. If sinus rhythm was not restored within 3 months, direct current (DC) cardioversion was performed. The incidence of adverse effects was also evaluated. Sinus rhythm was restored in seven (35%) of 20 patients in group A (average follow-up of 3.2 months) and in 17 (85%) of 20 in group B (average follow-up of 2.3 months) (p<0.05). After pharmacological or DC cardioversion, sinus rhythm could be maintained in 10 (50%) of 20 patients in group A (average follow-up of 14.7 months) and 15 (75%) of 20 patients in group B (average follow-up of 15.6 months). QT interval and QTc were significantly prolonged compare with the baseline values in group B, but no torsade de pointes was recognised in any of the patients. One patient in the group B developed interstitial pneumonia, but steroid therapy cured the condition.ConclusionsBepridil was superior to amiodarone in achieving sinus conversion and in maintaining sinus rhythm after cardioversion in patients with persistent AF. Even so, we must be watchful for potentially serious adverse complications when administering bepridil.</description><subject>amiodarone</subject><subject>Amiodarone - administration & dosage</subject><subject>Anti-Arrhythmia Agents - administration & dosage</subject><subject>arrhythmias</subject><subject>atrial fibrillation</subject><subject>Atrial Fibrillation - drug therapy</subject><subject>Atrial Fibrillation - physiopathology</subject><subject>bepridil</subject><subject>Bepridil - administration & dosage</subject><subject>Biological and medical sciences</subject><subject>brugada</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Cardioversion</subject><subject>Dose-Response Relationship, Drug</subject><subject>Drug dosages</subject><subject>Electrocardiography</subject><subject>Electrocardiography - drug effects</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart rate</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>lipids</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Performance evaluation</subject><subject>persistent atrial fibrillation</subject><subject>Prospective Studies</subject><subject>Sinuses</subject><subject>Studies</subject><subject>sudden cardiac death</subject><subject>Time Factors</subject><subject>torsade de pointes</subject><subject>Treatment Outcome</subject><issn>1355-6037</issn><issn>1468-201X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqNkUtv1DAUhSMEog_4BwhZQkhsQv2I7YQdDKUgVbDgIXbWjeMQD4k92M6U_hL-Lg6ZFokVq2v5fvfo6JyieETwc0KYOBsMhLR1Y0kxoSXDecg7xTGpRL18fb2b34zzUmAmj4qTGLcY46qpxf3iiFJRN5LQ4-LXed8bnezeOBMj8j2CyfoOgncG7U2Ic0St2QXb2RFZh0AP1uyt-4a0d8veeoeSR9G6TIbhOg3Twu0gWeNSRFc2DWi3gDHlDwQpWBhRb9tgxzFT3r1AgAK4zk82mg79AR4U93oYo3l4mKfF5zfnnzZvy8sPF-82Ly_LtqpYKpuKalET4KTCvMeSESmgNaThrO2krngvDOZcNo3mAIIxIWsjaMuAt1hLzE6LZ6vuLvgfs4lJZRPaZGfO-Dkqgimtc6SYZfTJP-jWz8Fld4rIGkvKJF-oaqV08DEG06sc3gThOkuppTh1U5xailNrcfns8UF8bifT3R7dNJWBpwcAooaxz4FpG_9yglCK8SJUrtyS98_bPYTvSsjsUL3_slG0udjQV_S1-pj5s5Vvp-3_Wf0NOCDDdQ</recordid><startdate>20120701</startdate><enddate>20120701</enddate><creator>Yamase, Miki</creator><creator>Nakazato, Yuji</creator><creator>Daida, Hiroyuki</creator><general>BMJ Publishing Group Ltd and British Cardiovascular Society</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20120701</creationdate><title>Effectiveness of amiodarone versus bepridil in achieving conversion to sinus rhythm in patients with persistent atrial fibrillation: a randomised trial</title><author>Yamase, Miki ; Nakazato, Yuji ; Daida, Hiroyuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b443t-942c681a51405f073176abe1953bd7c45f6e055799c5aa633678e62b3a5b0c703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>amiodarone</topic><topic>Amiodarone - administration & dosage</topic><topic>Anti-Arrhythmia Agents - administration & dosage</topic><topic>arrhythmias</topic><topic>atrial fibrillation</topic><topic>Atrial Fibrillation - drug therapy</topic><topic>Atrial Fibrillation - physiopathology</topic><topic>bepridil</topic><topic>Bepridil - administration & dosage</topic><topic>Biological and medical sciences</topic><topic>brugada</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Cardioversion</topic><topic>Dose-Response Relationship, Drug</topic><topic>Drug dosages</topic><topic>Electrocardiography</topic><topic>Electrocardiography - drug effects</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart rate</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>lipids</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Performance evaluation</topic><topic>persistent atrial fibrillation</topic><topic>Prospective Studies</topic><topic>Sinuses</topic><topic>Studies</topic><topic>sudden cardiac death</topic><topic>Time Factors</topic><topic>torsade de pointes</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yamase, Miki</creatorcontrib><creatorcontrib>Nakazato, Yuji</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart (British Cardiac Society)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yamase, Miki</au><au>Nakazato, Yuji</au><au>Daida, Hiroyuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectiveness of amiodarone versus bepridil in achieving conversion to sinus rhythm in patients with persistent atrial fibrillation: a randomised trial</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>2012-07-01</date><risdate>2012</risdate><volume>98</volume><issue>14</issue><spage>1067</spage><epage>1071</epage><pages>1067-1071</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>AimsPharmacological conversion to sinus rhythm is generally difficult to achieve, particularly in long-lasting persistent atrial fibrillation (AF). The purpose of this study is to compare the effectiveness of two agents, amiodarone and bepridil, in achieving conversion to sinus rhythm in patients with persistent AF.Methods and resultsAmiodarone (A) or bepridil (B) was administered to 40 consecutive patients (36 male subjects, age 61 years) with persistent AF in a prospective, randomised, open label fashion. The pharmacological effects in bringing about conversion to sinus rhythm and subsequently maintaining sinus rhythm were evaluated. If sinus rhythm was not restored within 3 months, direct current (DC) cardioversion was performed. The incidence of adverse effects was also evaluated. Sinus rhythm was restored in seven (35%) of 20 patients in group A (average follow-up of 3.2 months) and in 17 (85%) of 20 in group B (average follow-up of 2.3 months) (p<0.05). After pharmacological or DC cardioversion, sinus rhythm could be maintained in 10 (50%) of 20 patients in group A (average follow-up of 14.7 months) and 15 (75%) of 20 patients in group B (average follow-up of 15.6 months). QT interval and QTc were significantly prolonged compare with the baseline values in group B, but no torsade de pointes was recognised in any of the patients. One patient in the group B developed interstitial pneumonia, but steroid therapy cured the condition.ConclusionsBepridil was superior to amiodarone in achieving sinus conversion and in maintaining sinus rhythm after cardioversion in patients with persistent AF. Even so, we must be watchful for potentially serious adverse complications when administering bepridil.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>22689712</pmid><doi>10.1136/heartjnl-2012-302017</doi><tpages>5</tpages></addata></record> |
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| subjects | amiodarone Amiodarone - administration & dosage Anti-Arrhythmia Agents - administration & dosage arrhythmias atrial fibrillation Atrial Fibrillation - drug therapy Atrial Fibrillation - physiopathology bepridil Bepridil - administration & dosage Biological and medical sciences brugada Cardiac arrhythmia Cardiac dysrhythmias Cardiology. Vascular system Cardioversion Dose-Response Relationship, Drug Drug dosages Electrocardiography Electrocardiography - drug effects Female Follow-Up Studies Heart Heart rate Heart Rate - drug effects Humans lipids Male Medical sciences Middle Aged Performance evaluation persistent atrial fibrillation Prospective Studies Sinuses Studies sudden cardiac death Time Factors torsade de pointes Treatment Outcome |
| title | Effectiveness of amiodarone versus bepridil in achieving conversion to sinus rhythm in patients with persistent atrial fibrillation: a randomised trial |
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