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Electrophysiologic hemodynamic and metabolic effects of intravenous bepridil hydrochloride


American Journal of Cardiology 55(13 PART 1): 1589-1595
Electrophysiologic hemodynamic and metabolic effects of intravenous bepridil hydrochloride
Bepridil, a fast and slow channel blocking drug, was administered i.v. over 5 min in a dose of 3 mg/kg body wt to 19 patients. Ten patients received i.v. bepridil during electrophysiologic study, performed for the investigation of known or suspected cardiac arrhythmias. Sinus cycle length increased from 764 .+-. 56 to 886 .+-. 62 ms. AH [conduction interval] interval increased from 101 .+-. 6.9 to 137 .+-. 11.9 ms. HV [conduction interval] and QRS durations were not significantly affected. QTc interval increased from 395 .+-. 13 to 423 .+-. 13 ms. Atrial effective refractory period increased from 211 .+-. 8 to 242 .+-. 8.7 ms and atrioventricular nodel effective refractory period increased from 299 .+-. 26 to 366 .+-. 30 ms. Right ventricular effective refractory period increased from 233 .+-. 9.3 to 259 .+-. 8.1 ms. In an additional 9 patients with coronary artery disease, a hemodynamic and metabolic study was performed. A transient mean decrease dP/dt max from 1646 .+-. 164 to 1506 .+-. 238 mm Hg/s and a mean increase of 2.6 mm Hg in left ventricular end-diastolic pressure were observed. Both values had returned to control levels 15 min after drug infusion. Blood pressure, cardiac output, coronary sinus blood flow and myocardial lactate extraction ratio did not change significantly. This profile of powerful electrophysiologic and minor hemodynamic changes indicates a potentially useful role for bepridil in the acute management of supraventricular arrhythmias and, possibly, ventricular arrhythmias.

Accession: 005349337

PMID: 3873868

DOI: 10.1016/0002-9149(85)90978-6

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