Efficacy of oral bepridil in ventricular arrhythmias in stable coronary insufficiency

: The electrophysiological properties of bepridil suggest a possible ventricular antiarrhythmic effect. This prospective multicentre trial was undertaken to study the antiarrhythmic efficacy of oral bepridil on ventricular arrhythmias in patients with stable coronary insufficiency and more than 1 000 ventricular extrasystoles per 24 hours or ventricular tachycardia. The patients were divided into 3 groups according to the arrhythmias observed and the dosage used. In group I, the dosage was 300 mg/day and 12 out of 44 patients (27%) responded favourably to two criteria of efficacy (decrease of 84% of the number of ventricular extrasystoles; suppression of complex ventricular extrasystoles). In group II, the dosage was 300 mg/day, and then increased to 500 mg in non responders. Using the same criteria of efficacy, 13 out of 19 positive results were observed (68.4%). Group III comprised all cases of ventricular tachycardia; bepridil was effective in 3 out of 6 cases, associated with amiodarone in 1 case. The results demonstrate an antiarrhythmic effect of bepridil which is modest at 300 mg/day but which becomes more marked at the dosage of 500 mg/day.