{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:54:13Z","timestamp":1788411253144,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T00:00:00Z","timestamp":1746403200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The role of bepridil in preventing atrial fibrillation (AF) recurrence following ablation for persistent atrial fibrillation (PerAF) remains uncertain, particularly in patients with severe atrial substrates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 232 consecutive PerAF patients who underwent AF ablation between 2014 and 2019. Among them, 162 received bepridil for 3\u2009months post\u2010ablation (Bepridil group), while 70 received no antiarrhythmic drugs (No\u2010AADs group). Baseline characteristics, procedural details, and outcomes were compared. Kaplan\u2013Meier analysis and Cox regression models were used to evaluate AF\/atrial tachycardia (AT) recurrence, with bepridil use treated as a time\u2010dependent covariable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Bepridil group had a higher body mass index (25.1\u2009\u00b1\u20093.7 vs. 23.8\u2009\u00b1\u20093.9), a higher prevalence of patients with a LAD &gt;40\u2009mm and a LAV &gt;50\u2009mL (67.9% vs. 47.1%, 64.2% vs. 48.5%, respectively), and lower left atrial appendage flow velocity (37.6\u2009\u00b1\u200915.0 vs. 42.7\u2009\u00b1\u200920.5\u2009cm\/min). They more frequently underwent intracardiac atrial cardioversion (61.7% vs. 40.0%) and additional extra\u2010pulmonary vein ablation (35.2% vs. 15.7%), but were less likely to receive balloon\u2010based ablation (39.5% vs. 62.9%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 for all comparison). During a median follow\u2010up of 23.3\u2009months, AF\/AT\u2010free survival at 2\u2009years was comparable between the Bepridil and No\u2010AADs groups (80.4% vs. 81.7%; <jats:italic>p<\/jats:italic>\u2009=\u20090.61). This finding remained consistent after adjusting for baseline characteristics and considering bepridil as a time\u2010dependent covariable. No bepridil\u2010related adverse events occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Bepridil may have a limited role in preventing AF\/AT recurrence in PerAF patients, particularly those with severe atrial substrates. However, its overall impact appears to be small, warranting further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/joa3.70083","type":"journal-article","created":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T10:34:56Z","timestamp":1746441296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical insights into the role of bepridil in recurrence prevention after ablation of persistent atrial fibrillation"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2701-486X","authenticated-orcid":false,"given":"Moyuru","family":"Hirata","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Nihon University School of Medicine  Tokyo 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