Post-operative supraventricular tachycardia, a common complication following pulmonary resection, can be effectively managed with landiolol hydrochloride, an ultra-short-acting β1-blocker. A study published in 2011 investigated the efficacy of continuous intravenous infusion of landiolol in 25 patients who developed post-operative atrial fibrillation or atrial flutter after major pulmonary resection.
The study revealed a significant reduction in heart rate, decreasing from 135±24 bpm before landiolol infusion to a plateau rate of 85±19 bpm during infusion (P<0.0001). This heart rate reduction was observed in the majority of patients, demonstrating the drug's effectiveness in controlling rapid heart rates associated with supraventricular arrhythmias.
Conversion to Sinus Rhythm
Importantly, 14 patients (56%) experienced a conversion to normal sinus rhythm from supraventricular tachycardia following landiolol administration. This finding underscores the potential of landiolol in restoring normal heart rhythm in patients with post-operative atrial fibrillation or flutter. However, recurrence of supraventricular tachycardia after stopping landiolol infusion was observed in 17 patients (68%), but all patients without preoperative AF were cured of post-operative AF.
Safety Profile
The study also highlighted the safety profile of landiolol, with no detectable side effects reported, including no adverse influence on the circulatory and respiratory systems. This is a crucial consideration in post-operative patients, where minimizing complications is paramount.
Clinical Implications
These findings suggest that continuous intravenous infusion of landiolol is both effective and safe for managing supraventricular tachycardia in the post-operative setting following pulmonary resection. The drug's rapid onset and short duration of action allow for precise control of heart rate, making it a valuable tool for clinicians managing this common post-operative complication.
