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Practical applicability of landiolol, an ultra-short-acting ?1-selective blocker, for rapid atrial and ventricular tachyarrhythmias with left ventricular dysfunction.

ABSTRACT:

Background

Landiolol 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.

Methods

A 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.

Results

For 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.

Conclusions

Landiolol 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.

SUBMITTER: Wada Y

PROVIDER: S-EPMC4823575 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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

Wada Yuko Y Aiba Takeshi T Tsujita Yasuyuki Y Itoh Hideki H Wada Mitsuru M Nakajima Ikutaro I Ishibashi Kohei K Okamura Hideo H Miyamoto Koji K Noda Takashi T Sugano Yasuo Y Kanzaki Hideaki H Anzai Toshihisa T Kusano Kengo K Yasuda Satoshi S Horie Minoru M Ogawa Hisao H

Journal of arrhythmia 20151102 2

<h4>Background</h4>Landiolol 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.<h4>Methods</h4>A total of 39 patie ...[more]

PMID: 27092187

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