Antiarrhythmic Effect of Bisoprolol, a Highly Selective .BETA.1-Blocker, in Patients With Paroxysmal Atrial Fibrillation

Abstract

SUMMARYIn the treatment of arrhythmia, β-blockers are mainly used to regulate the heart rate. However, β-blockers are also known as drugs with an antiarrhythmic effect due to the suppression of sympathetic activity. We evaluated the antiarrhythmic effects of a highly selective β 1 -blocker, bisoprolol, in patients with diurnal paroxysmal atrial fibrillation (P-AF).A total of 136 patients with symptomatic diurnal P-AF were enrolled. Patients were divided into a diurnal-specific P-AF group and a diurnal & nocturnal P-AF group, as well as into a bisoprolol single use group and a combined use group with an antiarrhythmic drug. The effects of bisoprolol were evaluated in 3 categories: subjective symptom improvement, quality of life (QOL) improvement, and elimination of P-AF episode in Holter electrocardiograms (ECGs). For patients with effective treatment, a long-term effect up to 24 months was evaluated.Five patients (3.7%) discontinued bisoprolol due to side effects. Following administration of bisoprolol, 109 patients (80%) experienced subjective symptom improvement, 103 patients (76%) experienced QOL improvement, and elimination of P-AF episodes in ECGs was observed in 84 patients (62%). The elimination rate of P-AF episodes in ECGs was higher in the diurnal P-AF group than in the diurnal & nocturnal P-AF group (P = 0.042). There was no significant difference between the bisoprolol single use group and the combined use group. A long-term suppressive effect by bisoprolol was observed in 70 of 83 patients (84%).The results demonstrate that bisoprolol has an antiarrhythmic effect against sympathetic diurnal P-AF, improving subjective symptoms and QOL and eliminating P-AF episodes in ECGs. (Int Heart J 2008; 49: 281-293)

Comparative Effects of Carvedilol vs Bisoprolol for Severe Congestive Heart Failure - Special Reference to Atrial Fibrillation -

“…Ishiguro et al reported that bisoprolol has a defibrillation effect that causes AF to convert to sinus rhythm in paroxysmal AF patients because of reduction in HR. 27 In our study, reduction of HR was more prominent in the bisoprolol group than that in the carvedilol group at 18 months. Higher percentage of normal sinus rhythm in the bisoprolol group at 18 months could attribute to the lower HR in this group, because HR in AF patients reduces after defibrillation.…”

“…Several trials performed on Japanese patients with HF have shown that the BP and HR decrease adequately by administering low dosages of carvedilol and bisoprolol. 8, 27 Tamura et al also reported that low dosages of cavedilol significantly improve LVEF and BNP levels in HF patients after 6 months of treatment. 28 These differences in the dosages used between Japanese patients and other nationalities can be illustrated by the pharmacological heterogeneity of β-blockers.…”

Comparison of Atorvastatin and Simvastatin in Prevention of Atrial Fibrillation After Successful Cardioversion

“…[1][2][3][4][5] This is also emphasized in patients after successful cardioversion of AF. While ACE inhibitors and angiotensin receptor blockers are evidently effective to a certain extent, the beneficial effects of statins on AF prevention are still controversial.…”

Liquid chromatography tandem mass spectrometry method for determination of bisoprolol in human plasma using d5‐bisoprolol as the internal standard

“…Bisoprolol has an antiarrhythmic eff ect against sympathetic diurnal paroxysmal atrial fi brillation. It also signifi cantly reduces morbidity and mortality in stable chronic heart failure patients (Ishiguro et al, 2008;De Groote et al, 2007;Metra et al, 2007). Several previous reports have described the determination of bisoprolol in plasma using analytical methods including HPLC-FL (Taguchi et al, 2005;Braza et al, 2002;Eastwood et al, 1990;Horikiri et al, 1998), HPLC-DAD (Caudron et al, 2004), GC-MS (Shangguan et al, 2008) and LC-MS/MS Ding et al, 2007;Jovanovic et al, 2006;Bhatt et al, 2007;Kristoff ersen et al, 2007;Maurer et al, 2004).…”