Abstract 12577: Bepridil Prevents Ventricular Fibrillation Through Modification of Abnormal Repolarization Dynamics in Patients With Brugada Syndrome
Background: In patients with Brugada syndrome, bepridil could be effective for prevention of ventricular fibrillation (VF) through suppression of Ito. Hence, we assessed the effects of bepridil on repolarization dynamics and VF recurrence in patients with Brugada syndrome.
Methods: Twenty-six consecutive male patients with Brugada syndrome who had the type I ST elevation were categorized into 10 symptomatic (Sym) and 16 asymptomatic (Asym) groups. Unipolar V2 and V5 leads digital Holter ECG was recorded, and ST level (mm) at 40 msec after J point in V2 and QT interval (sec) in V5 were automatically measured. Both ST/RR and QT/RR linear regression lines were analyzed before and after bepridil therapy in Sym group, and in Asm group without any drugs. ST level and QT interval at RR intervals of both 0.6 sec (ST(0.6) and QT(0.6) ) and 1.2 sec ( QT(1.2) and ST(1.2) ) were also determined.
Results: During bepridil therapy, ST/RR slope and ST(1.2) in Sym group decreased from baseline and became smaller than those in Asym group. Before bepridil therapy, QT/RR slope and ST(1.2) in Sym group were smaller than those in Asym group. Bepridil significantly increased QT/RR slope, QT(0.6) and QT(1.2). The average episodes of VF markedly decreased from 3.8±5.4 (38±36 months) to 0.4±0.7 (48±26 months) by bepridil therapy.
Conclusion: Bepridil could be effective on suppression of VF recurrence by improving abnormal repolarization dynamics, i.e. augmentation of ST elevation with inhibited prolongation of QT interval during bradycardia, in symptomatic patients with Brugada syndrome.
- © 2011 by American Heart Association, Inc.