Novel use of the ultra-short-acting intravenous β1-selective blocker landiolol for supraventricular tachyarrhythmias in patients with congestive heart failure

Adachi, Tsutomu; Sato, Akira; Baba, Masakazu; Hiraya, Daigo; Hasegawa, Tomoaki; Kuroki, Kenji; Hoshi, Tomoya; Aonuma, Kazutaka

doi:10.1007/s00380-013-0377-3

Cited by 22 publications

(28 citation statements)

References 20 publications

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“…A low-dose β1-blocker, landiolol, in combination with milrinone, improves intracellular Ca 2+ handling in failing cardiomyocytes [14] . However, there are only a few clinical practice reports that examine how we can predict landiolol Responders and Non-Responders and patients who will experience adverse effects [15] , [16] , especially in a study population including patients with much lower LVEF (<25%). The aim of this study was to clarify the potential applicability of landiolol for rapid AF and refractory ventricular tachyarrhythmias (VTs) in patients with HF.…”

Section: Introductionmentioning

confidence: 99%

Practical applicability of landiolol, an ultra‐short‐acting β1‐selective blocker, for rapid atrial and ventricular tachyarrhythmias with left ventricular dysfunction

Wada

Aiba

Tsujita

et al. 2015

Journal of Arrhythmia

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BackgroundLandiolol effectively controls rapid heart rate in atrial fibrillation or flutter (AF/AFL) patients with left ventricular (LV) dysfunction. However, predicting landiolol Responders and Non-Responders and patients who will experience adverse effects remains a challenge. The aim of this study was to clarify the potential applicability of landiolol for rapid AF/AFL and refractory ventricular tachyarrhythmias (VTs) in patients with heart failure.MethodsA total of 39 patients with AF/AFL with ventricular response ≥120 bpm and 12 VTs were retrospectively enrolled. Landiolol Responders for rapid AF/AFL were defined as patients whose ventricular response was suppressed to less than 110 bpm or decreased by ≥20% from the initial heart rate after administration of landiolol. Responders for VTs were defined as patients with no recurrent VTs during the 24 h after the initiation of landiolol.ResultsFor AF/AFL, 29 patients (74%) were Responders. In nine patients (31%), AF was spontaneously terminated after starting landiolol. Eight Non-Responders (80%) needed to have AF terminated by cardioversion. Left ventricular ejection fraction (LVEF) at baseline was significantly associated with landiolol efficacy. For VTs, seven patients (58%) were Responders, and smaller LV diastolic and systolic diameters were associated with landiolol efficacy. Hypotension after landiolol treatment occurred in 5 of 51 patients, and lower LV systolic function was associated with the development of adverse events.ConclusionsLandiolol is effective in patients with heart failure not only due to rapid AF/AFL but also due to VTs. However, preserved LVEF is important for efficacy and safety in landiolol treatment.

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Section: Introductionmentioning

confidence: 99%

Practical applicability of landiolol, an ultra‐short‐acting β1‐selective blocker, for rapid atrial and ventricular tachyarrhythmias with left ventricular dysfunction

Wada

Aiba

Tsujita

et al. 2015

Journal of Arrhythmia

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“…In addition, Adachi et al reported that intravenous landiolol significantly reduced the heart rate during ATAs in patients with ADHF and a low LVEF despite the frequent concomitant use of intravenous inotropic drugs [22]. Of our patients, three received concomitant administration of intravenous dobutamine, and three received intra-aortic balloon pumping while their heart rates were reduced during landiolol therapy without leading to a marked reduction in blood pressure.…”

Section: Discussionmentioning

confidence: 83%

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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“…However, several studies have reported conflicting evidences about the efficacy of digoxin in such patients 27. One study proposed the use of landiolol to safely reduce the heart rate without suppressing cardiac function in patients with a reduced ejection fraction as well as in patients with severe LV dysfunction 28. Another study suggested that landiolol was more effective for urgent heart rate control than digoxin and did not increase the incidence of adverse events 29.…”

Section: Discussionmentioning

confidence: 99%

Newly developed atrial fibrillation progresses to a more severe INTERMACS score in a patient with advanced heart failure due to dilated cardiomyopathy

Saito

Amiya

Hatano

et al. 2017

Clinical Case Reports

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Novel use of the ultra-short-acting intravenous β1-selective blocker landiolol for supraventricular tachyarrhythmias in patients with congestive heart failure

Cited by 22 publications

References 20 publications

Practical applicability of landiolol, an ultra‐short‐acting β1‐selective blocker, for rapid atrial and ventricular tachyarrhythmias with left ventricular dysfunction

Practical applicability of landiolol, an ultra‐short‐acting β1‐selective blocker, for rapid atrial and ventricular tachyarrhythmias with left ventricular dysfunction

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

Newly developed atrial fibrillation progresses to a more severe INTERMACS score in a patient with advanced heart failure due to dilated cardiomyopathy

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