Landiolol,an ultra-short-actingβ1-blocker,is useful for managing supraventricular tachyarrhythmias in sepsis

• 作者: Masaki Okajima Masayuki Takamura Takumi Taniguchi
• 来源期刊: 世界重症医学杂志
• 学科: 医学
• 关键词: LANDIOLOL SUPRAVENTRICULAR TACHYARRHYTHMIAS SEPSIS Rate control Conversion to sinus RHYTHM
• 年，卷（期）: 2015,（3）
• 页码范围: 251-257
• 页数: 7页
• 分类号: R631.3

摘要

AIM:To investigate whether landiolol,an ultra-shortactingβ1-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.