Studies that aimed to evaluate the efficacy of landiolol in patients with cardiogenic shock and/atrial tachyarrhythmias
| Study . | Type of study . | Patients . | Age (years) . | LVEF (%) . | Rhythm . | HR (beats/min) . | Concomitant therapy . | Landiolol dose (μg/kg−1/min–1) . | Results . |
|---|---|---|---|---|---|---|---|---|---|
| Kobayashi et al.33 | Prospective | 20 | 56.2 ± 17.8 | 24 ± 7 | SR | 107.4 ± 12.3 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11% and PCWP and increased SvO2 and SVI. No changes in BP or CI were detected. Higher doses >3 μg/kg/min tended to decrease BP and CI whilst increasing PCWP and systemic vascular resistance. |
| Kobayashi et al.34 | Prospective | 23 | 72.7 ± 13.6 | 36.6 ± 7.6 | AF | 142.8 ± 18.4 | Inotropes (milrinone/dopamine/dobutamine), vasodilators diuretics | 1.5 ± 0.4 | Landiolol reduced HR by 22.4% 2 h after its initiation with no changes in BP. Conversion to SR was seen in 88% of patients with paroxysmal AF within 24 h of landiolol administration. |
| Kobayashi et al.35 | Prospective | 9 | 65.6 ± 15.8 | 27.8 ± 7.9 | AF | 138 ± 17.9 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11%, decreased PCWP and increased SVI without changes in BP. Administration of more than 3 μg/kg/min of landiolol decreased BP, CI and SVI. |
| Adachi et al.36 | Prospective | 52 | 64.8 ± 13.5 | 32.3 ± 11.9 | AF/AT | 133.2 ± 27.3 | Inotropes (milrinone/dobutamine), vasodilators diuretics | 1–20 | Landiolol at an average dose of 10.8 ± 9.4 μg/kg/min reduced significantly HR to 82 ± 15 beats/min with no effect in BP. In addition, it increased LVEF significantly to 39.7 ± 6.5% and was useful as a bridging treatment to additional therapy of oral blockade, pulmonary vein catheterization or cardiac resynchronization therapy. |
| Yoshima et al.37 | Retrospective | 33 | NA | DB + L: 38.9 ± 13.8 | AF/AFL/AT | DB + L: 147.4 ± 21.3 | Dobutamine | DB + L: 3.53 ± 2.45 | Negative chronotropic action by landiolol appeared not to be diminished even under concomitant administration of DB. |
| LM: 141.5 ± 18.7 | LM: 4.07 ± 2.44 | ||||||||
| LM: 44.8 ± 17 | |||||||||
| Kakihana et al.38 | Multicentre, open-label, randomized controlled trial | 151 | 67.1 | 55.1 | AF/AFL/SR | 117.5 | Conventional sepsis therapy, norepinephrine | 1–20 | Landiolol resulted in significantly more patients with sepsis-related tachyarrhythmia achieving a heart rate of 60–94 b.p.m. at 24 h and significantly reduced the incidence of new-onset arrhythmia. |
| Study . | Type of study . | Patients . | Age (years) . | LVEF (%) . | Rhythm . | HR (beats/min) . | Concomitant therapy . | Landiolol dose (μg/kg−1/min–1) . | Results . |
|---|---|---|---|---|---|---|---|---|---|
| Kobayashi et al.33 | Prospective | 20 | 56.2 ± 17.8 | 24 ± 7 | SR | 107.4 ± 12.3 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11% and PCWP and increased SvO2 and SVI. No changes in BP or CI were detected. Higher doses >3 μg/kg/min tended to decrease BP and CI whilst increasing PCWP and systemic vascular resistance. |
| Kobayashi et al.34 | Prospective | 23 | 72.7 ± 13.6 | 36.6 ± 7.6 | AF | 142.8 ± 18.4 | Inotropes (milrinone/dopamine/dobutamine), vasodilators diuretics | 1.5 ± 0.4 | Landiolol reduced HR by 22.4% 2 h after its initiation with no changes in BP. Conversion to SR was seen in 88% of patients with paroxysmal AF within 24 h of landiolol administration. |
| Kobayashi et al.35 | Prospective | 9 | 65.6 ± 15.8 | 27.8 ± 7.9 | AF | 138 ± 17.9 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11%, decreased PCWP and increased SVI without changes in BP. Administration of more than 3 μg/kg/min of landiolol decreased BP, CI and SVI. |
| Adachi et al.36 | Prospective | 52 | 64.8 ± 13.5 | 32.3 ± 11.9 | AF/AT | 133.2 ± 27.3 | Inotropes (milrinone/dobutamine), vasodilators diuretics | 1–20 | Landiolol at an average dose of 10.8 ± 9.4 μg/kg/min reduced significantly HR to 82 ± 15 beats/min with no effect in BP. In addition, it increased LVEF significantly to 39.7 ± 6.5% and was useful as a bridging treatment to additional therapy of oral blockade, pulmonary vein catheterization or cardiac resynchronization therapy. |
| Yoshima et al.37 | Retrospective | 33 | NA | DB + L: 38.9 ± 13.8 | AF/AFL/AT | DB + L: 147.4 ± 21.3 | Dobutamine | DB + L: 3.53 ± 2.45 | Negative chronotropic action by landiolol appeared not to be diminished even under concomitant administration of DB. |
| LM: 141.5 ± 18.7 | LM: 4.07 ± 2.44 | ||||||||
| LM: 44.8 ± 17 | |||||||||
| Kakihana et al.38 | Multicentre, open-label, randomized controlled trial | 151 | 67.1 | 55.1 | AF/AFL/SR | 117.5 | Conventional sepsis therapy, norepinephrine | 1–20 | Landiolol resulted in significantly more patients with sepsis-related tachyarrhythmia achieving a heart rate of 60–94 b.p.m. at 24 h and significantly reduced the incidence of new-onset arrhythmia. |
AF, atrial fibrillation; AFL, atrial flutter; AT, atrial tachycardia; BP, blood pressure; CI, cardiac index; DB, dobutamine; HR, heart rate; L, landiolol; LM, landiolol monotherapy; LVEF, left ventricular ejection fraction; NA, non-available; PCWP, pulmonary capillary wedge pressure; SR, sinus rhythm; SVI, stroke volume index; SvO2, oxygen saturation of mixed venous blood.
Studies that aimed to evaluate the efficacy of landiolol in patients with cardiogenic shock and/atrial tachyarrhythmias
| Study . | Type of study . | Patients . | Age (years) . | LVEF (%) . | Rhythm . | HR (beats/min) . | Concomitant therapy . | Landiolol dose (μg/kg−1/min–1) . | Results . |
|---|---|---|---|---|---|---|---|---|---|
| Kobayashi et al.33 | Prospective | 20 | 56.2 ± 17.8 | 24 ± 7 | SR | 107.4 ± 12.3 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11% and PCWP and increased SvO2 and SVI. No changes in BP or CI were detected. Higher doses >3 μg/kg/min tended to decrease BP and CI whilst increasing PCWP and systemic vascular resistance. |
| Kobayashi et al.34 | Prospective | 23 | 72.7 ± 13.6 | 36.6 ± 7.6 | AF | 142.8 ± 18.4 | Inotropes (milrinone/dopamine/dobutamine), vasodilators diuretics | 1.5 ± 0.4 | Landiolol reduced HR by 22.4% 2 h after its initiation with no changes in BP. Conversion to SR was seen in 88% of patients with paroxysmal AF within 24 h of landiolol administration. |
| Kobayashi et al.35 | Prospective | 9 | 65.6 ± 15.8 | 27.8 ± 7.9 | AF | 138 ± 17.9 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11%, decreased PCWP and increased SVI without changes in BP. Administration of more than 3 μg/kg/min of landiolol decreased BP, CI and SVI. |
| Adachi et al.36 | Prospective | 52 | 64.8 ± 13.5 | 32.3 ± 11.9 | AF/AT | 133.2 ± 27.3 | Inotropes (milrinone/dobutamine), vasodilators diuretics | 1–20 | Landiolol at an average dose of 10.8 ± 9.4 μg/kg/min reduced significantly HR to 82 ± 15 beats/min with no effect in BP. In addition, it increased LVEF significantly to 39.7 ± 6.5% and was useful as a bridging treatment to additional therapy of oral blockade, pulmonary vein catheterization or cardiac resynchronization therapy. |
| Yoshima et al.37 | Retrospective | 33 | NA | DB + L: 38.9 ± 13.8 | AF/AFL/AT | DB + L: 147.4 ± 21.3 | Dobutamine | DB + L: 3.53 ± 2.45 | Negative chronotropic action by landiolol appeared not to be diminished even under concomitant administration of DB. |
| LM: 141.5 ± 18.7 | LM: 4.07 ± 2.44 | ||||||||
| LM: 44.8 ± 17 | |||||||||
| Kakihana et al.38 | Multicentre, open-label, randomized controlled trial | 151 | 67.1 | 55.1 | AF/AFL/SR | 117.5 | Conventional sepsis therapy, norepinephrine | 1–20 | Landiolol resulted in significantly more patients with sepsis-related tachyarrhythmia achieving a heart rate of 60–94 b.p.m. at 24 h and significantly reduced the incidence of new-onset arrhythmia. |
| Study . | Type of study . | Patients . | Age (years) . | LVEF (%) . | Rhythm . | HR (beats/min) . | Concomitant therapy . | Landiolol dose (μg/kg−1/min–1) . | Results . |
|---|---|---|---|---|---|---|---|---|---|
| Kobayashi et al.33 | Prospective | 20 | 56.2 ± 17.8 | 24 ± 7 | SR | 107.4 ± 12.3 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11% and PCWP and increased SvO2 and SVI. No changes in BP or CI were detected. Higher doses >3 μg/kg/min tended to decrease BP and CI whilst increasing PCWP and systemic vascular resistance. |
| Kobayashi et al.34 | Prospective | 23 | 72.7 ± 13.6 | 36.6 ± 7.6 | AF | 142.8 ± 18.4 | Inotropes (milrinone/dopamine/dobutamine), vasodilators diuretics | 1.5 ± 0.4 | Landiolol reduced HR by 22.4% 2 h after its initiation with no changes in BP. Conversion to SR was seen in 88% of patients with paroxysmal AF within 24 h of landiolol administration. |
| Kobayashi et al.35 | Prospective | 9 | 65.6 ± 15.8 | 27.8 ± 7.9 | AF | 138 ± 17.9 | Milrinone, vasodilators, diuretics | 1.5–6 | Low-dose (1.5 μg/kg/min) landiolol reduced HR by 11%, decreased PCWP and increased SVI without changes in BP. Administration of more than 3 μg/kg/min of landiolol decreased BP, CI and SVI. |
| Adachi et al.36 | Prospective | 52 | 64.8 ± 13.5 | 32.3 ± 11.9 | AF/AT | 133.2 ± 27.3 | Inotropes (milrinone/dobutamine), vasodilators diuretics | 1–20 | Landiolol at an average dose of 10.8 ± 9.4 μg/kg/min reduced significantly HR to 82 ± 15 beats/min with no effect in BP. In addition, it increased LVEF significantly to 39.7 ± 6.5% and was useful as a bridging treatment to additional therapy of oral blockade, pulmonary vein catheterization or cardiac resynchronization therapy. |
| Yoshima et al.37 | Retrospective | 33 | NA | DB + L: 38.9 ± 13.8 | AF/AFL/AT | DB + L: 147.4 ± 21.3 | Dobutamine | DB + L: 3.53 ± 2.45 | Negative chronotropic action by landiolol appeared not to be diminished even under concomitant administration of DB. |
| LM: 141.5 ± 18.7 | LM: 4.07 ± 2.44 | ||||||||
| LM: 44.8 ± 17 | |||||||||
| Kakihana et al.38 | Multicentre, open-label, randomized controlled trial | 151 | 67.1 | 55.1 | AF/AFL/SR | 117.5 | Conventional sepsis therapy, norepinephrine | 1–20 | Landiolol resulted in significantly more patients with sepsis-related tachyarrhythmia achieving a heart rate of 60–94 b.p.m. at 24 h and significantly reduced the incidence of new-onset arrhythmia. |
AF, atrial fibrillation; AFL, atrial flutter; AT, atrial tachycardia; BP, blood pressure; CI, cardiac index; DB, dobutamine; HR, heart rate; L, landiolol; LM, landiolol monotherapy; LVEF, left ventricular ejection fraction; NA, non-available; PCWP, pulmonary capillary wedge pressure; SR, sinus rhythm; SVI, stroke volume index; SvO2, oxygen saturation of mixed venous blood.
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