Abstract 4628:Efficacy of Bepridil in Patients with Symptomatic Brugada Syndrome-The Relationship Between The Effects of Bepridil and SCN5A Mutation-

Abstract

Background : It has been reported that Bepridil prevents ventricular fibrillation (VF) in patients with symptomatic Brugada syndrome (BrS) because it depresses I to current. But the relationship between the effects of Bepridil and SCN5A mutation in patients with BrS is not known. Methods and Results : Low-dose (100mg/day) Bepridil was administered for seven patients (three with SCN5A mutation, four without SCN5A mutation; all men; age, 33 to 74 years) of BrS. If the effect was insufficient, Bepridil was escalated to 200mg/day. Three patients with SCN5A mutation had many VF episodes (patient A 22/72, B 11/38 and C 10/26; VF events/months) before low-dose Bepridil. But after low-dose Bepridil, most VF episodes were controlled (patient A 0/27, B 1/30 and C 1/29; VF events/months). All of four patients (patient D, E, F and G) without SCN5A mutation had relapses of VFs in a short term after low-dose Bepridil. One patient (patient E) suspected to have proarrhythmia needed cessation of Bepridil. In the other three patients, 200mg/day of Bepridil was administered. It was effective for one patient (patient G), but not effective for the other two patients (patient D and F). In patients with SCN5A mutation, parameters of signal-averaged electrocardiography (SAECG) were improved after low-dose Bepridil. But there was no improvement in SAECG of patients without SCN5A mutation (figure ). Conclusion : In patients of BrS with SCN5A mutation, low-dose Bepridil improved parameters of SAECG and controlled VF occurrence.