Effect of Ultra-Short-Acting .BETA.-Blocker Landiolol after Cardiovascular Surgery

Sugiura, T.; Koide, Masaaki; Kunii, Yoshifumi; Umehara, Nobuhiro; Watanabe, Kazumasa

doi:10.4326/jjcvs.38.179

Cited by 3 publications

(6 citation statements)

References 20 publications

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“…[12][13][14][15] The current study provides the first evidence that landiolol is effective for preventing Af after valve surgery. Thus, use of landiolol for postoperative Af is established and may lead to wide adoption of prophylactic administration of β -blockers after cardiac surgery.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Landiolol Hydrochloride for Prevention of Atrial Fibrillation After Heart Valve Surgery

et al. 2012

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SummaryThe goal of this prospective study was to examine the effects of landiolol hydrochloride on prevention of atrial fibrillation and on hemodynamics in the acute postoperative phase after heart valve surgery. The subjects were 60 patients who underwent valve surgery at our hospital from April 2008 to July 2010. The patients were randomly divided into two groups: the landiolol group (30 patients) and the control (no landiolol) group (30 patients). In the landiolol group, continuous intravenous landiolol was initiated immediately on admission to the intensive care unit at a dose of 10 μg/kg/ minute. Occurrence of atrial fibrillation was compared between the groups over an observation period of 72 hours after surgery. Atrial fibrillation occurred in 6 patients (20%) in the landiolol group and 16 (53.3%) in the control group during the observation period. Landiolol hydrochloride significantly reduced the occurrence of atrial fibrillation in the acute postoperative phase after heart valve surgery. Heart rate was significantly decreased by landiolol, but aggravation of hemodynamics was not observed. These results suggest that landiolol is a useful drug for prevention of atrial fibrillation after valve surgery. (Int Heart J 2012; 53: 359-363) Key words: Heart valve disease, Ultra-short acting β -blocker A trial fibrillation or flutter (Af) is frequently observed during the perioperative period of cardiac surgery, with a reported incidence of 17% to 65%. 1,2) Postoperative Af may aggravate hemodynamics and cause embolic diseases, including cerebral infarction, and therefore prevention of this condition is an important issue in postoperative management. Various drugs have been developed for Af, including β -blockers that are useful for treatment of arrhythmia by decreasing heart strain through an antihypertensive effect. However, excessive inhibition of myocardial contraction and the strength of the antihypertensive effect are of concern in administration of a β -blocker after cardiac surgery.Landiolol hydrochloride (Ono Pharmaceutical Co., Ltd., Osaka, Japan) is highly selective for the β 1 receptor 3) and exerts a lower antihypertensive effect compared with its effect in decreasing heart rate. 4) Thus, landiolol has less impact on hemodynamics in the acute phase after cardiac surgery, compared to conventional β -blockers. Furthermore, since landiolol has a very short serum half-life of approximately 4 minutes, 4) it is easy to adjust the blood concentration without decreasing blood pressure or cardiac output. Recently, the utility of landiolol has been reported for prevention of Af after coronary artery bypass grafting (CABG).5-8) However, to our knowledge, the efficacy of landiolol for prevention of Af after heart valve surgery has not been examined. Therefore, in this study, we examined the effect of landiolol on Af and hemodynamics after heart valve surgery. Methods Patients and protocol:The study was performed in 60 patients who underwent valve replacement or valvuloplasty at our hospital from April 2008 to ...

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Section: Discussionmentioning

confidence: 99%

Efficacy of Landiolol Hydrochloride for Prevention of Atrial Fibrillation After Heart Valve Surgery

et al. 2012

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“…[4][5][6][7][8][9][10] Postoperative SVT is common after cardiac surgery, with a reported incidence ranging from 11-40% after coronary bypass grafting and over 50% after valvular surgery. Previous reports have suggested that af is associated with an increased incidence of congestive heart failure, renal insufficiency, and stroke, all of which prolong hospitalization and increase the rate of rehospitalization after discharge.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8][9][10] In these studies, the dose of landiolol has ranged from 4.7 to 40 mg/kg/min under different clinical situations. [3][4][5][6][7][8][9][10] However, we have found that landiolol is effective for postoperative SVT at doses ranging from 2 to 5 mg/kg/min. Therefore, landiolol can be effective at doses lower than that recommended in the standard guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Premature termination of landiolol was not necessary in any of the patients, and many studies have also supported the safety of landiolol, which has a higher 1-selectvity than other -blockers that are currently available. [4][5][6][7][8][9][10] The occurrence of postoperative SVT was lower in the landiolol group compared with the control group, but the difference was not statistically significant. However, postoperative SVT during the continuous infusion of landiolol was suppressed significantly.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] The efficacy of landiolol for intraoperative and postoperative supraventricular tachyarrythmia (SVT) has been demonstrated in cardiac surgery and in other procedures. [4][5][6][7][8][9][10] However, the dose of landiolol has differed among these studies and has not been clearly determined. Postoperative SVT occurs in 11-40% of patients in coronary artery bypass grafting and in over 50% of patients after valvular surgery, and can lead to hemodynamic deterioration or thromboembolic complications.…”

Section: Introductionmentioning

confidence: 99%

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Safety and Efficacy of Low‐Dose Continuous Infusion of Landiolol, an Ultra‐Short‐Acting β‐blocker, in Cardiac Surgery

Sato¹,

Suenaga²,

Fumoto³

et al. 2011

Journal of Arrhythmia

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Introduction: Landiolol hydrochloride is an ultra-short-acting -blocker that is administered intravenously and has many advantages in cardiac surgery. This study was performed to examine the safety and efficacy of low-dose landiolol continuous infusion in cardiac surgery.Methods and Results: Nineteen patients who underwent either aortic valve replacement or coronary artery bypass surgery received low-dose continuous infusion of landiolol (2:8 AE 0:75 mg/kg/min) from the time of skin incision until the second postoperative day. Nineteen patients who did not receive landiolol served as controls. Heart rate, arterial pressure, cardiac index, and stroke volume were measured and the occurrence of supraventricular tachyarrythmia was monitored for one week after surgery. Landiolol decreased the heart rate without causing hemodynamic deterioration. The incidence of supraventricular tachyarrythmia was 32% and 47% in the landiolol and control groups, respectively (P ¼ 0:50).Conclusions: Landiolol is effective for decreasing heart rate while maintaining other hemodynamic parameters. Our data did not show a clear prophylactic effect of landiolol on postoperative supraventricular tachyarrythmia. (J Arrhythmia 2011; 27: 57-62)

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Safety and Efficacy of Low-Dose Continuous Infusion of Landiolol, an Ultra-Short-Acting β-blocker, in Cardiac Surgery

Sato¹,

Suenaga²,

Fumoto³

et al. 2011

J Arrhythmia

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Effect of Ultra-Short-Acting .BETA.-Blocker Landiolol after Cardiovascular Surgery

Cited by 3 publications

References 20 publications

Efficacy of Landiolol Hydrochloride for Prevention of Atrial Fibrillation After Heart Valve Surgery

Efficacy of Landiolol Hydrochloride for Prevention of Atrial Fibrillation After Heart Valve Surgery

Safety and Efficacy of Low‐Dose Continuous Infusion of Landiolol, an Ultra‐Short‐Acting β‐blocker, in Cardiac Surgery

Safety and Efficacy of Low-Dose Continuous Infusion of Landiolol, an Ultra-Short-Acting β-blocker, in Cardiac Surgery

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