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Efficacy of landiolol hydrochloride for atrial fibrillation after open heart surgery
Heart and Vessels, 06/08/2012
Clinical Article
Nishi H et al. – This ultra–short–acting β–blocker is a safe first–line treatment for postoperative atrial fibrillation (AF) after open heart surgery, and is most effective in patients who have undergone off–pump coronary artery bypass grafting.
Methods- Authors evaluated the efficacy and safety of landiolol hydrochloride for rhythm conversion in patients with postoperative AF.
- Among 134 patients who developed new–onset AF after open heart surgery between 2007 and 2009, 69 patients who received landiolol hydrochloride for treatment of postoperative AF were enrolled.
- The AF conversion rate, the percentage of patients with 20 % reduction of the ventricular rate, and the factors related to successful treatment were evaluated.
- Then, the landiolol group was compared with 65 patients who had postoperative AF and did not receive landiolol hydrochloride.
- Landiolol hydrochloride was the first–line treatment in 46 patients and the only therapy in 26 patients.
- Reversion to sinus rhythm was achieved in 51 patients, while the conversion rate in patients without landiolol hydrochloride was only 56.8 % (p < 0.05).
- A 20 % reduction of the ventricular rate was achieved more frequently in the landiolol group.
- Although landiolol hydrochloride was highly effective in patients who had undergone off–pump coronary artery bypass grafting, patients with cardiopulmonary bypass did not respond as well.
- The heart rate was reduced from 130 ± 26 to 81 ± 12 (p < 0.05) after landiolol administration, while blood pressure did not decrease significantly.
- Landiolol hydrochloride was effective for conversion of postoperative AF.