Skip Navigation


Europace Advance Access originally published online on November 11, 2009
Europace 2009 11(12):1620-1623; doi:10.1093/europace/eup363
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
11/12/1620    most recent
eup363v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Miyazaki, S.
Right arrow Articles by Takahashi, A.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Miyazaki, S.
Right arrow Articles by Takahashi, A.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Ablation for Atrial Fibrillation

Pharmacological cardioversion preceding left atrial ablation: bepridil predicts the clinical outcome following ablation in patients with persistent atrial fibrillation

Shinsuke Miyazaki1,*, Taishi Kuwahara1, Atsushi Kobori1, Yoshihide Takahashi1, Asumi Takei1, Akira Sato1, Mitsuaki Isobe2 and Atsushi Takahashi1

1 Cardiovascular Center, Yokosuka Kyosai Hospital, Yonegahamadori, 1-16, Yonegahamadori, Yokosuka, Kanagawa 238-8558, Japan; 2 Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan

Aims: Bepridil is highly effective in terminating persistent atrial fibrillation (AF). Despite continued treatment, a high rate of AF recurrence after pharmacological cardioversion (PC) with bepridil has been reported. Bepridil therapy is also associated with significant adverse effects.

Methods and results: This retrospective case–control study included 82 patients with persistent AF (PEF). Group 1 (22 patients) comprised cases undergoing AF ablation following attempted PC with bepridil. Group 2 (60 patients) comprised control that underwent AF ablation without bepridil pre-treatment. In Group 1, 15 patients (68%) restored sinus rhythm (SR) with bepridil (SR group) and 7 continued to have AF (AF group). SR group underwent extensive pulmonary vein isolation (EPVI) alone. AF group and Group 2 underwent linear ablation after EPVI, if AF was inducible. At the end of 18 ± 5 months off antiarrhythmic drugs, the AF-free rate was 87% in SR group, 29% in AF group, and 72% in Group 2 (72 vs. 29%, P = 0.02).

Conclusion: Following AF ablation in patients who successfully restored SR with bepridil pre-treatment, AF-free rate was significantly higher than in those who failed to do so. Conversion to SR with bepridil might help select the optimal patients with PEF for catheter ablation.

Key Words: Pharmacological cardioversion, Atrial fibrillation, Catheter ablation, Extensive pulmonary vein isolation, Bepridil

* Corresponding author. Tel: +81 468 22 2710, Fax: +81 468 25 2103, Email: mshinsuke{at}k3.dion.ne.jp

Manuscript submitted 7 August 2009. Accepted after revision 20 October 2009.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.