Efficacy of low-dose landiolol, an ultrashort-acting β-blocker, on postoperative atrial fibrillation in patients undergoing pulmonary resection for lung cancer

• Published in: General thoracic and cardiovascular surgery Vol. 59; no. 12; pp. 799 - 805
• Main Authors: Nojiri, Takashi, Yamamoto, Kazuhiro, Maeda, Hajime, Takeuchi, Yukiyasu, Funakoshi, Yasunobu, Maekura, Ryoji, Okumura, Meinoshin
• Format: Journal Article
• Language: English
• Published: Japan Springer Japan 01.12.2011; Springer Nature B.V
• Subjects: Adrenergic beta-Antagonists - administration & dosage; Aged; Arrhythmia; Atrial Fibrillation - prevention & control; Cardiac arrhythmia; Cardiac Surgery; Cardiology; Female; Hemodynamics - drug effects; Humans; Infusions, Intravenous; Lung cancer; Lung cancer surgery; Lung Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Morpholines - administration & dosage; Original Article; Perioperative care; Pneumonectomy - adverse effects; Postoperative Complications - prevention & control; Surgical Oncology; Thoracic Surgery; Urea - administration & dosage; Urea - analogs & derivatives; Arrhythmia; Lung cancer surgery; Perioperative care
• ISSN: 1863-6705; 1863-6713; 1863-6713
• DOI: 10.1007/s11748-011-0841-x

Purpose Postoperative atrial fibrillation is the most common complication encountered during the early postoperative period following a pulmonary resection procedure. Landiolol is a newly developed, ultrashortacting, β-adrenoceptor antagonist. The objective of the present study was to evaluate the efficacy and safety of low-dose landiolol for postoperative atrial fibrillation in patients undergoing pulmonary resection for lung cancer. Methods Of 553 patients who underwent an elective pulmonary resection procedure for lung cancer at National Toneyama Hospital from January 2005 to December 2009, this analysis involved 30 consecutive patients who developed atrial fibrillation after surgery and needed treatment. These patients were divided into two groups: the landiolol group ( n = 15) and the historical control group (treated with a combination of verapamil and digoxin, n = 15). Hemodynamic changes before and 30 min, 2 h, and 12 h after medication, the time required to restore sinus rhythm, and adverse events were evaluated. Results There were no significant differences between the two groups regarding blood pressure before and after medication. Heart rate was reduced immediately in both groups after medication and was significantly lower in the landiolol group than in the control group. The time to restore sinus rhythm was significantly shorter in the landiolol group than in the control group (8.1 ± 11.0 h vs. 23.0 ± 26.0 h, P < 0.05). In none of the subjects with the landiolol infusion was it discontinued because of side effects. Conclusion Low-dose landiolol can be effective quickly and used safely in patients who develop atrial fibrillation after pulmonary resection for lung cancer.