Abstract
The electrophysiologic properties of bepridil, a calcium channel blocker with additional effects on fast response tissues, were investigated in 10 patients with atrioventricular accessory pathways. Seven patients had Wolff-Parkinson-White syndrome, and three had concealed atrioventricular pre-excitation. A dose of 4 mg/kg was administered intravenously over five minutes. Bepridil increased the AH interval and the functional refractory period of the atrioventricular node. The effective refractory periods of the right atrium and right ventricle were also increased. Bepridil prolonged refractoriness in the accessory pathway both in the anterograde and retrograde direction. After bepridil administration it was impossible to induce reciprocating tachycardia electrically in two patients because of conduction block in the normal pathway. On the other hand, the zone of tachycardia was often increased after bepridil. Nevertheless, the heart rate during tachycardia was slowed by depression of conduction in both the normal and accessory pathways. The findings of this study provide a basis for the antiarrhythmic action of bepridil in patients with atrioventricular accessory pathways.
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Selected References
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- Campbell R. W., Smith R. A., Gallagher J. J., Pritchett E. L., Wallace A. G. Atrial fibrillation in the preexcitation syndrome. Am J Cardiol. 1977 Oct;40(4):514–520. doi: 10.1016/0002-9149(77)90065-0. [DOI] [PubMed] [Google Scholar]
- Canicave J. C., Deu J., Jacq J., Paillet R. Un nouvel antiangoreux, le bépridil. Appréciation de son efficacité par l'épreuve d'effort au cours d'un assai à double insu contre placebo. Therapie. 1980 Sep-Oct;35(5):607–612. [PubMed] [Google Scholar]
- Durrer D., Schoo L., Schuilenburg R. M., Wellens H. J. The role of premature beats in the initiation and the termination of supraventricular tachycardia in the Wolff-Parkinson-White syndrome. Circulation. 1967 Nov;36(5):644–662. doi: 10.1161/01.cir.36.5.644. [DOI] [PubMed] [Google Scholar]
- Fauchier J. P., Cosnay P., Néel C., Rouesnel P., Bonnet P., Quilliet L. Traitement des tachycardies supraventriculaires et ventriculaires paroxystiques par le bépridil. Arch Mal Coeur Vaiss. 1985 Apr;78(4):612–619. [PubMed] [Google Scholar]
- Gallagher J. J., Pritchett E. L., Sealy W. C., Kasell J., Wallace A. G. The preexcitation syndromes. Prog Cardiovasc Dis. 1978 Jan-Feb;20(4):285–327. doi: 10.1016/0033-0620(78)90015-4. [DOI] [PubMed] [Google Scholar]
- Gulamhusein S., Ko P., Carruthers S. G., Klein G. J. Acceleration of the ventricular response during atrial fibrillation in the Wolff-Parkinson-White syndrome after verapamil. Circulation. 1982 Feb;65(2):348–354. doi: 10.1161/01.cir.65.2.348. [DOI] [PubMed] [Google Scholar]
- Leclercq J. F., Kural S., Valère P. E. Bépridil et torsades de pointes. Arch Mal Coeur Vaiss. 1983 Mar;76(3):341–348. [PubMed] [Google Scholar]
- Levy S., Cointe R., Metge M., Faugere G., Valeix B., Gerard R. Bepridil for recurrent sustained ventricular tachycardias: assessment using electrophysiologic testing. Am J Cardiol. 1984 Sep 1;54(6):579–581. doi: 10.1016/0002-9149(84)90252-2. [DOI] [PubMed] [Google Scholar]
- Rowland E., McKenna W. J., Krikler D. M. Electrophysiologic and antiarrhythmic actions of bepridil. Comparison with verapamil and ajmaline for atrioventricular reentrant tachycardia. Am J Cardiol. 1985 Jun 1;55(13 Pt 1):1513–1519. doi: 10.1016/0002-9149(85)90964-6. [DOI] [PubMed] [Google Scholar]
- Roy D., Montigny M., Klein G. J., Sharma A. D., Cassidy D. Electrophysiologic effects and long-term efficacy of bepridil for recurrent supraventricular tachycardias. Am J Cardiol. 1987 Jan 1;59(1):89–92. doi: 10.1016/s0002-9149(87)80076-0. [DOI] [PubMed] [Google Scholar]
- Scherlag B. J., Lau S. H., Helfant R. H., Berkowitz W. D., Stein E., Damato A. N. Catheter technique for recording His bundle activity in man. Circulation. 1969 Jan;39(1):13–18. doi: 10.1161/01.cir.39.1.13. [DOI] [PubMed] [Google Scholar]
- Svenson R. H., Miller H. C., Gallagher J. J., Wallace A. G. Electrophysiological evaluation of the Wolff-Parkinson-White syndrome: problems in assessing antegrade and retrograde conduction over the accessory pathway. Circulation. 1975 Oct;52(4):552–562. doi: 10.1161/01.cir.52.4.552. [DOI] [PubMed] [Google Scholar]
- Upward J. W., Daly K., Campbell S., Bergman G., Jewitt D. E. Electrophysiologic, hemodynamic and metabolic effects of intravenous bepridil hydrochloride. Am J Cardiol. 1985 Jun 1;55(13 Pt 1):1589–1595. doi: 10.1016/0002-9149(85)90978-6. [DOI] [PubMed] [Google Scholar]
- Valère P. E., Belin A., Chentir T., Lehner J. P., Guerot C., Tricot R. Effets électrophysiologiques du bépridil sur le coeur humain. Ann Cardiol Angeiol (Paris) 1982 Jul-Sep;31(5):409–415. [PubMed] [Google Scholar]
- Vogel S., Crampton R., Sperelakis N. Blockade of myocardial slow channels by bepridil (CERM-1978). J Pharmacol Exp Ther. 1979 Sep;210(3):378–385. [PubMed] [Google Scholar]
- Winslow E., Kane K. A. Supraventricular antidysrhythmic and electrophysiological effects of bepridil, a new antianginal agent. J Cardiovasc Pharmacol. 1981 Jul-Aug;3(4):655–667. doi: 10.1097/00005344-198107000-00001. [DOI] [PubMed] [Google Scholar]
- Wit A. L., Weiss M. B., Berkowitz W. D., Rosen K. M., Steiner C., Damato A. N. Patterns of atrioventricular conduction in the human heart. Circ Res. 1970 Sep;27(3):345–359. doi: 10.1161/01.res.27.3.345. [DOI] [PubMed] [Google Scholar]
