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

Haehling, Stephan von; Bělohlávek, Jan; Er, Fikret; Gassanov, Natig; Guarracino, Fabio; Bouvet, Olivier

doi:10.1093/eurheartj/sux035

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…However, it may be important to characterize LV systolic function when initiating landiolol treatment [ 19 ]. Wada et al reported that an extremely low LVEF (< 25%) was a predictor of inadequate heart-rate lowering during landiolol therapy and was associated with the development of adverse events, such as hypotension [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…The pharmacokinetic properties of landiolol indicate that it is rapidly metabolized in plasma by pseudocholinesterase and has a very short elimination half-life of approximately 4 min [ 15 , 16 ]. Recently, landiolol has been reported to be useful for heart rate control in AF patients with HF or reduced left ventricular (LV) systolic dysfunction [ 19 ]. However, the effect of landiolol on ATAs complicated with acute decompensated HF (ADHF) has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Intravenous Landiolol on Heart Rate and Outcomes in Patients with Atrial Tachyarrhythmias and Acute Decompensated Heart Failure: A Single-Center Experience

Matsui

Suzuki

Shiga

et al. 2019

Drugs - Real World Outcomes

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ObjectiveAtrial tachyarrhythmias (ATAs) lead to clinical deterioration and worsening heart failure (HF) in patients with acute decompensated HF (ADHF). We evaluated the effects of the ultrashort-acting intravenous β1-blocker landiolol on the heart rate, hemodynamics, and outcome in patients with ATAs and ADHF.MethodsA total of 67 consecutive hospitalized patients with ATAs and ADHF who were treated with landiolol (36 males, 67 ± 12 years) were included in this single-center retrospective study. The primary endpoints were changes in heart rate and systolic blood pressure from baseline during intravenous landiolol administration. The secondary endpoints included restoration of sinus rhythm and outcomes.ResultsThe median maintenance dose of intravenous landiolol was 3.0 (range 1.0–12.0) μg/kg/min and the median treatment duration was 5 (range 1–24) days. Intravenous landiolol reduced heart rate (141 ± 17 beats/min at baseline to 99 ± 20 beats/min at 6 h, P < 0.001) without a marked reduction in blood pressure or deterioration of HF. During landiolol treatment, 15 (22%) patients had spontaneously restored sinus rhythm. Eight patients experienced in-hospital death, and 41 (69%) were discharged with sinus rhythm. During the follow-up of 16 ± 12 months, patients with sinus rhythm showed a lower frequency of rehospitalization due to worsening HF than patients with ATAs (5/41 vs. 7/18, P = 0.019).ConclusionsOur results showed that intravenous landiolol reduces the heart rate without markedly decreasing blood pressure in patients with ATAs and ADHF. Approximately 70% of the discharged patients were in sinus rhythm, and these patients showed a lower frequency of rehospitalization due to worsening HF (UMIN-CTR no. UMIN000033650).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Intravenous Landiolol on Heart Rate and Outcomes in Patients with Atrial Tachyarrhythmias and Acute Decompensated Heart Failure: A Single-Center Experience

Matsui

Suzuki

Shiga

et al. 2019

Drugs - Real World Outcomes

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“…Rate control with landiolol in HFrEF and AF Landiolol is not widely used for those with cardiac dysfunction in Europe thus far, although such an indication is receiving great concern. 27,28 In the current European Society of Cardiology guideline published in 2016, 29 the smallest dose of β-blocker is recommended as a first-line to achieve rate control in case of atrial fibrillation with cardiac dysfunction, followed by amiodarone and digoxin.…”

Section: Post-j-land Study Guidelinesmentioning

confidence: 99%

Novel rate control strategy with landiolol in patients with cardiac dysfunction and atrial fibrillation

Imamura

Kinugawa

2020

ESC Heart Failure

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While patients with acute heart failure often have tachycardia with atrial fibrillation, there have been no established medical tools that control tachycardia safely and definitely. Digoxin has been recommended as a first choice in the former guidelines, but it takes time to affect and has a risk of adverse events particularly for those with chronic kidney disease. Landiolol is a recently innovated ultra-short-acting beta-blocker with 251-fold β1/β2 selectivity, which was originally indicated only to control peri-operative supra-ventricular tachyarrhythmia by 2013 in Japan. We aimed to review how to use landiolol in patients with cardiac dysfunction and tachycardia due to atrial fibrillation. We reviewed recently conducted randomized control trials using landiolol, recently updated guidelines, as well as current practical use of landiolol. Japan landiolol vs. Digoxin (J-Land) study demonstrated that landiolol was more effective to control tachycardia than digoxin in atrial fibrillation patients with left ventricular dysfunction in 2013. Given the result, the revised Japanese heart failure guideline recommends landiolol for rate control during atrial fibrillation in acute heart failure patients as Class IIa with evidence level B. Currently in Japan, landiolol is used for rate control, even in patients with advanced heart failure receiving continuous infusion of inotropes. The clinical use of landiolol in patients with cardiac dysfunction and tachycardia due to atrial fibrillation is increasing. Further studies are warranted to investigate the implication of faster and safer rate control using landiolol.

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“…Esant sumažėjusiai KS IF (<40 proc. ), rekomenduojama landiololio dozė neturėtų viršyti 10 µg/kg/ minutę [20]. Vieno centro studijoje nustatyta, jog landiololio skyrimas pacientams su ŪDŠN pagerino ligos baigtį ir sumažino pakartotinių hospitalizacijų kiekį [14].…”

Section: Rezultatai Ir Jų Aptarimasunclassified

Klinikinė Landiololio Reikšmė Gydant Aritmijas Bei Covid-19

Alonderytė¹,

Umantas²,

Samalavičius³

et al. 2020

Health Sciences

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Tikslas – atlikti mokslinių šaltinių, nagrinėjančių landiololio vartojimą aritmijoms gydyti, sisteminę analizę ir apibendrinti šio vaisto panaudojimo galimybes ir naudą. Medžiaga ir metodai. Duomenys buvo renkami PubMed duomenųbazėje. Analizei naudoti visateksčiai straipsniai, atitikę apžvalgos tikslą. Analizuotos tik anglųkalba skelbtos publikacijos, pasirodžiusios ne vėliau nei prieš10 metų. Analizei atrinktos ir išanalizuotos 33 publikacijos. Rezultatai. Landiololis yra labai trumpo veikimo β1 receptorių blokatorius, skiriamas sinusinei tachikardijai, prieširdžių virpėjimui ir plazdėjimui gydyti [1]. Šis medikamentas labai kardioselektyvus (β1/ β2=255), lyginant su kitais β-adrenerginių receptorių blokatoriais, todėl retinamas širdies susitraukimų dažnis, o arterinis kraujospūdis išlieka beveik nepakitęs [2]. Landiololio vartojimas intraveninis, todėl patogu jį titruoti iki reikiamos dozės ūmių būklių metu. Remiantis tyrimų rezultatais, teigiamas efektas stebimas skiriant šį vaistą ūminio koronarinio sindromo bei ūminio dekompensuoto širdies nepakankamumo metu [3]. Landiololis pranašenis už digoksiną, kontroliuojant širdies susitraukimų dažnį prieširdinių aritmijų metu pacientams, kurių kairiojo skilvelio funkcija yra sutrikusi [4]. Landiololis efektyvus ne tik supraventrikulinėms aritmijoms valdyti. Jis gali būti naudingas ir gydant ventrikulines aritmijas (skilvelinę tachikardiją ar skilvelių virpėjimą), kai kiti medikamentai neveiksmingi [5, 6]. Mažos landiololio dozės gali būti skiriamos operacijų metu ar po jų, siekiant išvengti pooperacinio prieširdžių virpėjimo [7]. Atliekant aortokoronarinių jungčių suformavimo operaciją su vožtuvų plastika, pastebėta, jog pooperacinio prieširdžių virpėjimo gydymui landiololis buvo tinkamesnis už diltiazemą [8]. Atliktuose tyrimuose aprašoma ekonominė landiololio vartojimo nauda prevencijai ar pooperacinio prieširdžių virpėjimo gydymui [9]. β-adrenerginių receptorių blokatoriai gali būti naudingi mažinant viruso patekimą į ląstelę COVID-19 pacientams, turintiems normalų kraujospūdį ar sergantiems arterine hipertenzija [10].

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

Cited by 8 publications

References 26 publications

Effects of Intravenous Landiolol on Heart Rate and Outcomes in Patients with Atrial Tachyarrhythmias and Acute Decompensated Heart Failure: A Single-Center Experience

Effects of Intravenous Landiolol on Heart Rate and Outcomes in Patients with Atrial Tachyarrhythmias and Acute Decompensated Heart Failure: A Single-Center Experience

Novel rate control strategy with landiolol in patients with cardiac dysfunction and atrial fibrillation

Klinikinė Landiololio Reikšmė Gydant Aritmijas Bei Covid-19

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