Landiolol for managing atrial fibrillation in post-cardiac surgery

Abstract

Landiolol is an intravenous ultra-short acting beta-blocker which has been used in Japan for many years to prevent and/or to treat post-operative atrial fibrillation following cardiac surgery. The drug is now available in Europe. This article is a systematic review of literature regarding the use of landiolol in that specific surgical setting.

Landiolol: pharmacology and its use for rate control in atrial fibrillation in an emergency setting

“…Higher doses (20–40 mcg/kg/min up to 80 mcg/kg/min) are required for treating intra-operative paroxysmal supraventricular tachycardia (PSVT), sinus tachycardia, 11–14 and patients in an emergency department setting (H. Domanovits et al , unpublished data), 15 , 16 than those suitable to control heart rate of patients with perioperative AF 18 and patients with AF and cardiac dysfunction managed in cardiac 19 and intensive care units 20 (5–10 mcg/kg/min). The use of landiolol in these settings will be covered by other articles of this supplement, 21–24 while experience in the emergency department setting will be described below. A dose ranging study 14 evaluating landiolol efficacy and safety to control heart rate of supraventricular tachycardia in an emergency department compared three dose regimens: Low (0.063 mg/kg loading +20 mcg/kg/min), Moderate (0.125 mg/kg loading +40 mcg/kg/min), and High (0.250 mg/kg loading +80 mcg/kg/min).…”

Atrial Fibrillation After Coronary Artery Bypass Surgery: Risk Factors, Prevention and Treatment

“…По результатам нескольких мета-анализов были сделаны выводы, что ландиолол снижает риск развития ПОФП в 2,8 раза. Препарат позволяет контролировать ритм сердца, быстро снижать частоту сердечных сокращений (ЧСС) с минимальным воздействием на уровень АД, уменьшает частоту ПОФП без увеличения частоты развития осложнений, что де-ОБЗОРЫ § лает ландиолол перспективным препаратом для использования в кардиохирургии [86,87]. Ландиолол в течение длительного времени использовался в Японии для профилактики ПОФП, в настоящее время доступен и одобрен в Европе, однако в Российской Федерации препарат пока не зарегистрирован.…”

Landiolol for rate control management of atrial fibrillation in patients with cardiac dysfunction

“…Landiolol has been safely used to control heart rate (HR) in patients with HF and AF, showing limited impact on blood pressure and good tolerance. 13 , 15–24 Landiolol has been also used to prevent AF in post-cardiac surgery patients with cardiac dysfunction, 25 which will be discussed in a review article of this supplement by Fellahi et al 26 …”