World J Crit Care Med. 2015 Aug 04;4(3):251-7. doi: 10.5492/wjccm.v4.i3.251. eCollection 2015 Aug 04.
Landiolol, an ultra-short-acting β1-blocker, is useful for managing supraventricular tachyarrhythmias in sepsis.
World journal of critical care medicine
Masaki Okajima, Masayuki Takamura, Takumi Taniguchi
Affiliations
Affiliations
- Masaki Okajima, Takumi Taniguchi, Intensive Care Unit, Kanazawa University Hospital, Kanazawa 920-8641, Japan.
PMID: 26261777
PMCID: PMC4524822 DOI: 10.5492/wjccm.v4.i3.251
Abstract
AIM: To investigate whether landiolol, an ultra-short-acting β1-antagonist, can safely and effectively control heart rate in septic patients with supraventricular tachyarrhythmias.
METHODS: We reviewed all patients with sepsis who admitted to our intensive care unit between January 2006 and December 2011. Sixty one septic patients suffered from supraventricular tachyarrhythmias (heart rate ≥ 120 bpm for > 1 h). Among 61 patients, 39 patients were treated with landiolol (landiolol group) and 22 patients were not treated with landiolol (control group). Arterial pressure, heart rate, cardiac rhythm, pulmonary arterial pressure and cardiac output (if a pulmonary arterial catheter was inserted) were compared between the 2 groups at 1, 8 and 24 h after the initiation of tachyarrhythmias.
RESULTS: Mean age and Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores were similar between the 2 groups. Paroxysmal atrial fibrillation/flutter (87%), paroxysmal atrial tachycardia (10%), and paroxysmal supraventricular tachycardia (3%) were observed. The initial landiolol dose administered was 6.3 ± 5.8 g/kg per minute. Rapid and substantial reduction of heart rate was observed in the landiolol group without any deterioration of hemodynamics. Landiolol significantly reduced heart rate (from 145 ± 14 bpm to 90 ± 20 bpm) compared to the control group (from 136 ± 21 bpm to 109 ± 18 bpm, P < 0.05). The conversion to sinus rhythm was observed more frequently in the landiolol group than in the control group at every point (P < 0.01 at 8 h; P < 0.05 at 1 and 24 h).
CONCLUSION: Landiolol safely reduced heart rate and, in part, converted to sinus rhythm in septic patients with supraventricular tachyarrhythmias.
Keywords: Conversion to sinus rhythm; Landiolol; Rate control; Sepsis; Supraventricular tachyarrhythmias
References
- J Manipulative Physiol Ther. 1992 Jan;15(1):10-5 - PubMed
- J Cardiovasc Pharmacol. 1999 Jul;34(1):70-7 - PubMed
- J Intensive Care Med. 2008 May-Jun;23(3):178-83 - PubMed
- Circ J. 2013;77(4):908-16 - PubMed
- Chem Pharm Bull (Tokyo). 1992 Jun;40(6):1462-9 - PubMed
- Circ Shock. 1984;14(3):189-201 - PubMed
- Int Heart J. 2009 Sep;50(5):627-41 - PubMed
- J Crit Care. 2008 Dec;23(4):532-6 - PubMed
- Nature. 2002 Jan 10;415(6868):198-205 - PubMed
- Ann Surg. 1973 Jul;178(1):102-7 - PubMed
- Brain Res Bull. 1991 Sep-Oct;27(3-4):305-8 - PubMed
- Crit Care Med. 1988 Nov;16(11):1132-7 - PubMed
- QJM. 2007 Oct;100(10):629-34 - PubMed
- Can J Anaesth. 2003 Aug-Sep;50(7):753 - PubMed
- J Anesth. 2008;22(1):64-9 - PubMed
- J Anesth. 2004;18(4):304-6 - PubMed
- J Cardiovasc Pharmacol. 1998 Mar;31(3):431-40 - PubMed
- Masui. 2003 May;52(5):515-8 - PubMed
- Circ Shock. 1988 Feb;24(2):133-41 - PubMed
- Biol Pharm Bull. 2012;35(10):1655-60 - PubMed
- Clin Pharmacol Ther. 2000 Aug;68(2):143-50 - PubMed
- Can J Anaesth. 2001 Nov;48(10):985-9 - PubMed
- Physiol Rev. 2007 Apr;87(2):457-506 - PubMed
- Neuroscience. 1993 Aug;55(4):1037-43 - PubMed
- J Anesth. 2008;22(4):361-6 - PubMed
- Circ J. 2012;76(5):1097-101 - PubMed
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