Novel Use of an Ultra-Short-Acting Intravenous Beta Blocker, Landiolol for Supraventricular Tachyarrhythmias in Patients with Severe Congestive Heart Failure
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<B>Background:</B> Supraventricular tachyarrythemias (SVTs) with left ventricular dysfunction often make the hemodynamics worsen and induce congestive heart failure. We investigated clinical efficacy of ultra-short acting intravenous beta-blocker (landiolol) for SVTs in patients with severe left ventricular dysfunction. <B>Methods:</B> We evaluated 48 patients with SVTs (AF/32, AFL/12, AT/4) and symptom of heart failure (NYHA III/IV, 8/40) on admission. Left ventricular ejection fraction on admission was 28.6±8.6%. Underlying heart disease included ischemic heart disease (n=18), non-ischemic cardiomyopathy (n=24) and valvular disease (n=6). Landiolol was administered with an infusion rate of 1 µg/kg/min and, if no adverse effects developed, this was increased to 5 µg/kg/min. <B>Results:</B> The heart rate was 128.1±22.5 beats/min at baseline and significantly decreased to 86.2±18.6 beats/min (p<0.01), while systolic blood pressure did not differ from baseline at effective dose level (97.5±20 to 96.3±18.8, p=ns). Two patients withdrew administering landiolol because of low output syndrome. Other 46 patients improved from NYHA Class IV to III (n=38) and III to II (n=5) by controlling heart rate. After stabilization of patient’s condition, these patients could be discharged with additional treatments, involved catheter ablation and cardiac resynchronized therapy. <B>Conclusions:</B> Intravenous low doses of landiolol may be useful as a bridge to additional treatment in patients with congestive heart failure.
- Journal of Arrhythmia
Journal of Arrhythmia 27(Supplement), OP49_4-OP49_4, 2011
Japanese Heart Rhythm Society