Safety and Efficacy of Low-Dose Continuous Infusion of Landiolol, an Ultra-Short-Acting β-blocker, in Cardiac Surgery

Introduction: Landiolol hydrochloride is an ultra-short-acting β-blocker that is administered intravenously and has many advantages in cardiac surgery. This study was performed to examine the safety and efficacy of low-dose landiolol continuous infusion in cardiac surgery.Methods and Results: Nineteen patients who underwent either aortic valve replacement or coronary artery bypass surgery received low-dose continuous infusion of landiolol (2.8 ± 0.75 μg/kg/min. from the time of skin incision until the second postoperative day. Nineteen patients who did not receive landiolol served as controls. Heart rate, arterial pressure, cardiac index, and stroke volume were measured and the occurrence of supraventricular tachyarrythmia was monitored for one week after surgery. Landiolol decreased the heart rate without causing hemodynamic deterioration. The incidence of supraventricular tachyarrythmia was 32% and 47% in the landiolol and control groups, respectively (P = 0.50).Conclusions: Landiolol is effective for decreasing heart rate while maintaining other hemodynamic parameters. Our data did not show a clear prophylactic effect of landiolol on postoperative supraventricular tachyarrythmia.