Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol

<p>Abstract</p> <p>Background</p> <p>Landiolol hydrochloride is a new β-adrenergic blocker with a pharmacological profile that suggests it can be administered safely to patients who have sinus tachycardia or tachyarrhythmia and who require heart rate reduction. This stu...

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Main Authors: Nakanishi Kazuhiro, Takeda Shinhiro, Kim Chol, Kohda Shusuke, Sakamoto Atsuhiro
Format: Article
Language:English
Published: BMC 2013-01-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:http://www.cardiothoracicsurgery.org/content/8/1/19
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author Nakanishi Kazuhiro
Takeda Shinhiro
Kim Chol
Kohda Shusuke
Sakamoto Atsuhiro
author_facet Nakanishi Kazuhiro
Takeda Shinhiro
Kim Chol
Kohda Shusuke
Sakamoto Atsuhiro
author_sort Nakanishi Kazuhiro
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>Landiolol hydrochloride is a new β-adrenergic blocker with a pharmacological profile that suggests it can be administered safely to patients who have sinus tachycardia or tachyarrhythmia and who require heart rate reduction. This study aimed to investigate whether intraoperative administration of landiolol could reduce the incidence of atrial fibrillation (AF) after cardiac surgery.</p> <p>Methods</p> <p>Of the 200 consecutive patients whose records could be retrieved between October 2006 and September 2007, we retrospectively reviewed a total of 105 patients who met the inclusion criteria: no previous permanent/persistent AF, no permanent pacemaker, no renal insufficiency requiring dialysis, and no reactive airway disease, etc. Landiolol infusion was started after surgery had commenced, at an infusion rate of 1 μg/kg/min, titrated upward in 3–5 μg/kg/min increments. The patients were divided into 2 groups: those who received intraoperative β-blocker therapy with landiolol (landiolol group) and those who did not receive any β-blockers during surgery (control group). An unpaired <it>t</it> test and Fisher’s exact test were used to compare between-group differences in mean values and categorical data, respectively.</p> <p>Results</p> <p>Seventeen of the 105 patients (16.2%) developed postoperative atrial fibrillation: 5/57 (8.8%) in the landiolol group and 12/48 (25%) in the control group. There was a significant difference between the two groups (P=0.03). The incidence of AF after valve surgery and off-pump coronary artery bypass grafting was lower in the landiolol group, although the difference between the groups was not statistically significant.</p> <p>Conclusions</p> <p>Our retrospective review demonstrated a marked reduction of postoperative AF in those who received landiolol intraoperatively. A prospective study of intraoperative landiolol for preventing postoperative atrial fibrillation is warranted.</p>
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spelling doaj.art-658d6c9423d147c4a0c11dd3b01375fd2022-12-22T01:16:49ZengBMCJournal of Cardiothoracic Surgery1749-80902013-01-01811910.1186/1749-8090-8-19Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiololNakanishi KazuhiroTakeda ShinhiroKim CholKohda ShusukeSakamoto Atsuhiro<p>Abstract</p> <p>Background</p> <p>Landiolol hydrochloride is a new β-adrenergic blocker with a pharmacological profile that suggests it can be administered safely to patients who have sinus tachycardia or tachyarrhythmia and who require heart rate reduction. This study aimed to investigate whether intraoperative administration of landiolol could reduce the incidence of atrial fibrillation (AF) after cardiac surgery.</p> <p>Methods</p> <p>Of the 200 consecutive patients whose records could be retrieved between October 2006 and September 2007, we retrospectively reviewed a total of 105 patients who met the inclusion criteria: no previous permanent/persistent AF, no permanent pacemaker, no renal insufficiency requiring dialysis, and no reactive airway disease, etc. Landiolol infusion was started after surgery had commenced, at an infusion rate of 1 μg/kg/min, titrated upward in 3–5 μg/kg/min increments. The patients were divided into 2 groups: those who received intraoperative β-blocker therapy with landiolol (landiolol group) and those who did not receive any β-blockers during surgery (control group). An unpaired <it>t</it> test and Fisher’s exact test were used to compare between-group differences in mean values and categorical data, respectively.</p> <p>Results</p> <p>Seventeen of the 105 patients (16.2%) developed postoperative atrial fibrillation: 5/57 (8.8%) in the landiolol group and 12/48 (25%) in the control group. There was a significant difference between the two groups (P=0.03). The incidence of AF after valve surgery and off-pump coronary artery bypass grafting was lower in the landiolol group, although the difference between the groups was not statistically significant.</p> <p>Conclusions</p> <p>Our retrospective review demonstrated a marked reduction of postoperative AF in those who received landiolol intraoperatively. A prospective study of intraoperative landiolol for preventing postoperative atrial fibrillation is warranted.</p>http://www.cardiothoracicsurgery.org/content/8/1/19β-blockerLandiololPostoperative atrial fibrillationCardiac surgery
spellingShingle Nakanishi Kazuhiro
Takeda Shinhiro
Kim Chol
Kohda Shusuke
Sakamoto Atsuhiro
Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol
Journal of Cardiothoracic Surgery
β-blocker
Landiolol
Postoperative atrial fibrillation
Cardiac surgery
title Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol
title_full Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol
title_fullStr Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol
title_full_unstemmed Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol
title_short Postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery: intraoperative use of landiolol
title_sort postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting or cardiac valve surgery intraoperative use of landiolol
topic β-blocker
Landiolol
Postoperative atrial fibrillation
Cardiac surgery
url http://www.cardiothoracicsurgery.org/content/8/1/19
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