Successful Management of Tachycardiac Atrial Fibrillation in a Septic Patient with Landiolol

Yoshida, Yasuhiko; Hongo, Takashi; Sakamoto, Atsuhiro; Ogawa, Ryo

doi:10.1213/01.ane.0000140814.28118.6f

Cited by 25 publications

(18 citation statements)

References 2 publications

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“…The regimen recommended on the packaging insert is a loading dose of 125 µg·kg −1 ·min −1 , followed by a maintenance dose of 10-40 µg·kg −1 ·min −1 , but we achieved the desired effect at a lower dose. Some other reports have also indicated that a lower dose of landiolol was effective [18][19][20]. In high-risk patients with hypertension and ischemic heart disease whose cardiac function and reserve is decreased, the beta-adrenergic blocking effect is stronger, and the frequency of low BP is increased [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Clinical role and efficacy of landiolol in the intensive care unit

et al. 2008

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Beta-adrenergic receptor blockers have proved to be effective for the management of various cardiovascular diseases and the prevention of perioperative cardiac events and cerebrovascular accidents. Landiolol is a short-acting beta-blocker, with high beta 1-selectivity and a short duration of action. We thought landiolol was valuable and suitable for intensive care unit (ICU) patients, and conducted a retrospective study. The records of 80 patients (58 post-surgical patients; group S and 22 internal medicine patients; group IM) were reviewed. Thirty-seven (64%) of the group S patients were post-coronary artery bypass graft surgery, and the IM group consisted mostly of patients with acute myocardial infarction. The most common indication for landiolol in group S was the prevention of myocardial ischemia (50%), and in group IM, it was atrial fibrillation (45%). The median infusion rate of landiolol was 5 microg.kg(-1).min(-1) and the median infusion time was 2 days. Twenty-six patients were continued on oral beta-adrenergic receptor blockers. Landiolol reduced heart rate significantly without reducing blood pressure, and stabilized hemodynamics. We confirmed that landiolol is valuable as a bridge to starting oral beta-adrenergic receptor blockers and as an anti-arrhythmic agent, and that it is suitable for ICU patients due to its high beta 1-selectivity and rapid onset and offset of action.

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Section: Discussionmentioning

confidence: 99%

Clinical role and efficacy of landiolol in the intensive care unit

et al. 2008

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“…Landiolol is the most ultra-short-acting (t 1/2 : 4 min) intravenous β 1 -selective adrenergic receptor blocker (β 1 /β 1 ratio: 277) known; it has a significant chronotropic effect and little or no negative inotropic effect at low doses, as previously reported [13,15,16,17,18]. Even if the BP decreased with landiolol, it could be quickly restored to baseline levels by stopping its administration because it is a very-short-acting drug.…”

Section: Discussionmentioning

confidence: 67%

“…The important difference between esmolol and landiolol is that the latter has a greater chronotropic effect and a lesser inotropic effect than the former, as reported previously [13,15,16,17,18]. Recently, we reported that low-dose landiolol (1.5 µg·kg -1 ·min -1 ) safely decreased the HR in patients with severe ADHF and sinus tachycardia, thereby improving cardiac function, whereas high-dose landiolol (>3.0 µg·kg -1 ·min -1 ) suppressed cardiac function [13].…”

Section: Introductionmentioning

confidence: 56%

“…Continuous intravenous infusion of landiolol (1.0-2.0 µg·kg -1 ·min -1 ) or digoxin (0.25 mg) was then administered, and the ECG and BP were monitored for 24 h. Landiolol is an ultra-short-acting (elimination t 1/2 : 4 min) intravenous β-adrenergic receptor blocker that has a high β 1 selectivity (β 1 /β 2 = 277). Due to its ultra-short duration of activity [13,15,16,17,18], the acute hemodynamic changes were measurable immediately after landiolol was administered.…”

Section: Methodsmentioning

confidence: 99%

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A Low-Dose β<sub>1</sub>-Blocker Effectively and Safely Slows the Heart Rate in Patients with Acute Decompensated Heart Failure and Rapid Atrial Fibrillation

et al. 2013

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Objective: Recently, we reported that low-dose landiolol (1.5 µg·kg^-1·min^-1), an ultra-short-acting β-blocker, safely decreased the heart rate (HR) in patients with acute decompensated heart failure (ADHF) and sinus tachycardia, thereby improving cardiac function. We investigated whether low-dose landiolol effectively decreased the HR in ADHF patients with rapid atrial fibrillation (AF). Methods: We enrolled 23 ADHF patients with rapid AF (HR ≥120 beats·min^-1 and New York Heart Association class III-IV) and systolic heart failure (SHF: n = 12) or diastolic heart failure (DHF: n = 11) who received conventional therapy with diuretics, vasodilators, and/or low-dose inotropes. They were administered continuous intravenous infusion of low-dose landiolol (1.0-2.0 µg·kg^-1·min^-1), and their electrocardiograms and blood pressures were monitored for 24 h thereafter. Results: Two hours after starting landiolol, the HR was reduced significantly (22%), without a reduction in blood pressure, and remained constant thereafter. The HR reduction 2 h after landiolol administration was significantly greater in the DHF group than in the SHF group. No incidence of hypotension was recorded. Conclusions: Digitalis or amiodarone is currently recommended for HR control in ADHF patients with rapid AF. Our results showed that continuous infusion of low-dose landiolol may also be useful as first-line therapy in these patients.

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“…One such agent is landiolol, a new potent selective β 1 -adrenoceptor antagonist, used in the treatment of tachyarrhythmias [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

High concentrations of landiolol, a β1-adrenoceptor antagonist, stimulate smooth muscle contraction of the rat trachea through the Rho-kinase pathway

et al. 2008

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Successful Management of Tachycardiac Atrial Fibrillation in a Septic Patient with Landiolol

Cited by 25 publications

References 2 publications

Clinical role and efficacy of landiolol in the intensive care unit

Clinical role and efficacy of landiolol in the intensive care unit

A Low-Dose β<sub>1</sub>-Blocker Effectively and Safely Slows the Heart Rate in Patients with Acute Decompensated Heart Failure and Rapid Atrial Fibrillation

High concentrations of landiolol, a β1-adrenoceptor antagonist, stimulate smooth muscle contraction of the rat trachea through the Rho-kinase pathway

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