Combination therapy of renin angiotensin system inhibitors and bepridil is useful for maintaining sinus rhythm in patients with atrial fibrillation.

Abstract

BACKGROUND:

The present study evaluated the effect of treatment renin angiotensin system inhibitors (RAS-I) for maintaining sinus rhythm after conversion from persistent atrial fibrillation. As the efficacy of RAS-I in atrial fibrillation is unclear, our study evaluated conversion to and maintenance of sinus rhythm by combination therapy with RAS-I and bepridil in patients in atrial fibrillation.

METHODS:

Bepridil was administered to 125 consecutive patients with paroxysmal and persistent atrial fibrillations. Two groups of patients were compared: The bepridil group was treated with bepridil alone, the RAS-I group with bepridil plus angiotensin II receptor blockers or angiotensin converting enzyme inhibitors. The primary end point was length of time to first recurrence of atrial fibrillation.

RESULTS:

Maintenance of sinus rhythm was achieved in 25 patients (45%) in the bepridil group and 44 patients (63%) in the RAS-I group (persistent and paroxysmal atrial fibrillations). The difference between the bepridil group and the RAS-I group was significant (p < 0.05). Maintenance of sinus rhythm was achieved in 9 of 25 patients (36%) in the bepridil group, and in 22 of 35 patients (62%) in the RAS-I group with persistent atrial fibrillation. The difference between the bepridil group and the RAS-I group was significant (p < 0.05). Bepridil plus RAS-I was particularly effective at preventing the recurrence of atrial fibrillation in patients with left ventricular dysfunction (left ventricular ejection fraction < 50%).

CONCLUSIONS:

Combination therapy with RAS-I and bepridil may be useful for maintenance of sinus rhythm.

• Authors: Mitsuharu Kawamura, Hiroyuki Ito, Tatsuya Onuki, Fumito Miyoshi, Yoshino Minoura, Taku Asano, Kaoru Tanno, Youichi Kobayashi
• Journal: Journal of cardiology (J Cardiol) Vol. 50 Issue 6 Pg. 343-50 (Dec 2007) ISSN: 0914-5087 [Print] Netherlands
• PMID: 18186308 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• Anti-Arrhythmia Agents
• Bepridil

Topics

• Aged
• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors (administration & dosage)
• Anti-Arrhythmia Agents (administration & dosage)
• Atrial Fibrillation (drug therapy, physiopathology)
• Bepridil (administration & dosage)
• Drug Therapy, Combination
• Female
• Humans
• Male
• Ventricular Dysfunction, Left (drug therapy)