Abstract 14796: Landiolol, an Ultra-Short-Acting Beta1 Selective Blocker, is Useful for the Management of Tachyarrhythmia in Patients with Severe Infection
Background: Tachyarrhythmia has been reported to be independently associated with mortality in critically ill patients with sepsis. The control of heart rate (HR) may be important but is often difficult because of unstable hemodynamics in such patients. Landiolol is an ultra-short-acting β1 selective blocker and could be valuable and suitable for the management of tachyarrhythmia in patients with severe infection.
Objective: To investigate the hemodynamic effects of landiolol in patients with severe infection and tachyarrhythmia.
Methods: We reviewed all patients with systemic inflammatory response syndrome and infection who admitted to our intensive care unit between January 2006 and December 2009. Among them, patients who suffered from tachyarrhythmia (HR>120bpm for more than 1h) were chosen and divided to two groups: landiolol group (n=39) and control (non-landiolol) group (n=22). Arterial pressure, HR, pulmonary arterial pressure, cardiac output and cardiac index were compared retrospectively between two groups at 1, 8 and 24h after the initiation of tachyarrhythmia.
Results: Mean age, APACHE II and SOFA score were similar in two groups. Paroxysmal atrial fibrillation/flutter (77%), paroxysmal atrial tachycardia (7%) and paroxysmal supraventricular tachycardia (16%) were observed. Initial dose of landiolol was 6.3±3.3μg/kg/min. Rapid and substantial reduction of HR was observed in landiolol group without any deterioration of hemodynamics (figure). Landiolol significantly reduced HR (from 145±14bpm to 90±20bpm) when compared to control group (from 136±21bpm to 109±18bpm) as indicated in figure. In addition, the conversion to sinus rhythm from supraventricular arrhythmia was observed more frequently in landiolol group than in control group at any points (figure).
Conclusions: Landiolol reduced HR safely and, in part, converted to sinus rhythm from supraventricular tachyarrhythmia in patients with severe infection.
- © 2010 by American Heart Association, Inc.