• Shigeki Kobayashi, Wakako Murakami, Takeki Myoren, Hiroki Tateishi, Shinichi Okuda, Masahiro Doi, Tomoko Nao, Yasuaki Wada, Masunori Matsuzaki, and Masafumi Yano.
• Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
• Cardiology. 2014 Jan 1; 127 (2): 105-13.

ObjectiveRecently, we reported that low-dose landiolol (1.5 µg·kg(-1)·min(-1)), an ultra-short-acting β-blocker, safely decreased the heart rate (HR) in patients with acute decompensated heart failure (ADHF) and sinus tachycardia, thereby improving cardiac function. We investigated whether low-dose landiolol effectively decreased the HR in ADHF patients with rapid atrial fibrillation (AF).MethodsWe enrolled 23 ADHF patients with rapid AF (HR ≥120 beats·min(-1) and New York Heart Association class III-IV) and systolic heart failure (SHF: n = 12) or diastolic heart failure (DHF: n = 11) who received conventional therapy with diuretics, vasodilators, and/or low-dose inotropes. They were administered continuous intravenous infusion of low-dose landiolol (1.0-2.0 µg·kg(-1)·min(-1)), and their electrocardiograms and blood pressures were monitored for 24 h thereafter.ResultsTwo hours after starting landiolol, the HR was reduced significantly (22%), without a reduction in blood pressure, and remained constant thereafter. The HR reduction 2 h after landiolol administration was significantly greater in the DHF group than in the SHF group. No incidence of hypotension was recorded.ConclusionsDigitalis or amiodarone is currently recommended for HR control in ADHF patients with rapid AF. Our results showed that continuous infusion of low-dose landiolol may also be useful as first-line therapy in these patients.© 2013 S. Karger AG, Basel.

19 keywords...

hide…