The Resurfacing of Bepridil Hydrochloride on the World Stage as an Antiarrhythmic Drug for Atrial Fibrillation

Bepridil hydrochloride is a multiple ion channel blocker with relatively strong suppressive effects for various K+ channels. Recent clinical studies mainly done in Japan have revealed the eficacy of the agent for the management of atrial fibrillation (AF). The pharmacological conversion effect for persistent AF seems particularly promising. The agent also has robust effects in maintaining sinus rhythm after pharmacological or electrical conversion, as well as suppressing recurrent attacks of paroxysmal AF. Though torsades de pointes may develop due to QT prolongation, an appropriate dosage and careful follow-up can prevent this serious complication. Now that the antiarrhythmic eficacy of bepridil for AF is recognized in Japan, the agent is poised to resurface on the world stage as a treatment for AF.