International Journal of Cardiovascular and Thoracic Surgery

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Administration of Low-Dose Landiolol Prevents Postoperative Atrial Fibrillation After Aortic Valve Replacement

Background: Postoperative atrial fibrillation (POAF), a common complication of cardiac surgery, increases postoperative mortality, morbidity, and medical costs. POAF after coronary artery bypass grafting is well investigated; however, little is known about POAF after aortic valve replacement (AVR). This study aimed to investigate the efficacy of low-dose landiolol in preventing POAF after AVR. Methods: Thirty patients who underwent AVR were randomized into two groups, with or without administration of landiolol (Landiolol, N=15; Control, N=15). In Landiolol, continuous infusion of landiolol (3 µg/kg/min) was maintained for 48 h from admission to the intensive care unit. The occurrence of POAF during seven days after surgery, heart rate, blood pressure, cardiac index, and mixed venous oxygen saturation were compared between the two groups. Results: POAF occurred in one and seven patients in Landiolol (6.7%) and Control (46.7%), respectively, with significantly lower incidence in Landiolol than in Control (p=0.0352). The heart rate was significantly lower in Landiolol than in Control. No significant differences were observed in blood pressure, cardiac indices, and mixed venous hemoglobin oxygen between the two groups. Conclusions: The administration of low-dose landiolol following AVR significantly decreased the incidence of POAF without hemodynamic deterioration, suggesting that it may safely and effectively prevent POAF in patients undergoing AVR.

Landiolol, POAF, AVR

APA Style

Takeshi Oda, Ryusuke Mori, Eiki Tayama, Shigeaki Aoyagi. (2023). Administration of Low-Dose Landiolol Prevents Postoperative Atrial Fibrillation After Aortic Valve Replacement. International Journal of Cardiovascular and Thoracic Surgery, 9(4), 56-62. https://doi.org/10.11648/j.ijcts.20230904.13

ACS Style

Takeshi Oda; Ryusuke Mori; Eiki Tayama; Shigeaki Aoyagi. Administration of Low-Dose Landiolol Prevents Postoperative Atrial Fibrillation After Aortic Valve Replacement. Int. J. Cardiovasc. Thorac. Surg. 2023, 9(4), 56-62. doi: 10.11648/j.ijcts.20230904.13

AMA Style

Takeshi Oda, Ryusuke Mori, Eiki Tayama, Shigeaki Aoyagi. Administration of Low-Dose Landiolol Prevents Postoperative Atrial Fibrillation After Aortic Valve Replacement. Int J Cardiovasc Thorac Surg. 2023;9(4):56-62. doi: 10.11648/j.ijcts.20230904.13

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Creswell LL, Schuessler RB, Rosenbloom M, et al. Hazards of postoperative atrial arrhythmias. Ann Thorac Surg. 1993; 56: 539-49.
2. Shen J, Lall Shelly, Zheng V, et al. The persistent problem of new-onset postoperative atrial fibrillation: a single-institution experience over two decades. J Thorac Cardiovasc Surg. 2011; 141: 559-70.
3. Greenberg JW, Lancaster TS, Schuessler RB, et al. Postoperative atrial fibrillation following cardiac surgery: a persistent complication. Eur J Cardiothorac Surg. 2017; 52: 665-72.
4. Woldendorp K, Farag J, Khadra S, et al. Postoperative atrial fibrillation after cardiac surgery: a meta-analysis. Ann Thorac Surg. 2021; 112: 2084-93.
5. Eikelboom R, Sanjanwala R, Le ML, et al. Postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis. Ann Thorac Surg. 2021; 111: 544-55.
6. Filardo G, Damiano RJ Jr, Ailawadi G, et al. Epidemiology of new-onset atrial fibrillation following coronary artery bypass graft surgery. Heart. 2018; 104: 985-92.
7. Phan K, Ha HS, Phan S, Medi C, Thomas SP, Yan TD. New-onset atrial fibrillation following coronary bypass surgery predicts long-term mortality: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2015; 48: 817-24.
8. White CM, Kluger J, Lertsburapa K, et al. Effect of preoperative angiotensin converting enzyme inhibitor or angiotensin receptor blocker use on the frequency of atrial fibrillation after cardiac surgery: a cohort study from the atrial fibrillation suppression trials II and III. Eur J Cardiothorac Surg. 2007; 31: 717-20.
9. Tamura K, Arai H, Ito F, et al. Pravastatin treatment before coronary artery bypass grafting for reduction of postoperative atrial fibrillation. Gen Thorac Cardiovasc Surg. 2010; 58: 120-5.
10. Mclntyre WF. Post-operative atrial fibrillation after cardiac surgery: challenges throughout the patient journey. Front Cardiovasc Med. 2023; DOI: 10.3389/fcvm.2023.1156626.
11. Fujiwara H, Sakurai M, Namai A, et al. Effect of low-dose landiolol, an ultrashort-acting β-blocker, on postoperative atrial fibrillation after CABG surgery. Gen Thorac Cardiovasc Surg. 2009; 57: 132-7.
12. Sezai A, Minimi K, Nakai T, et al. Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: new evidence from the PASCAL trial. J Thorac Cardiovasc Surg. 2011; 141: 1478-87.
13. Sezai A, Nakai T, Hata M, et al. Feasibility of landiolol and bisoprolol for prevention of atrial fibrillation after coronary artery bypass grafting: a pilot study. J Thorac Cardiovasc Surg. 2012; 144: 1241-8.
14. Fujii M, Bessho R, Ochi M, et al. Effect of postoperative landiolol administration for atrial fibrillation after off pump coronary artery bypass surgery. J Cardiovasc Surg. 2012; 53: 369-74.
15. Osumi M, Tashiro T, Morita Y, et al. Preventive effect of intraoperative landiolol administration on atrial fibrillation after off-pump coronary artery bypass grafting. Adv Ther. 2014; 31: 1109-17.
16. Nagaoka E, Arai H, Tamura K, et al. Prevention of atrial fibrillation with ultra-low dose landiolol after off-pump coronary artery bypass grafting. Ann Thorac Cardiovasc Surg. 2014; 20: 129-34.
17. Sakaguchi M, Sasaki Y, Hirai H, et al. Efficacy of landiolol hydrochloride for prevention of atrial fibrillation after heart valve surgery. Int Heart J. 2012; 53: 359-63.
18. Yokota J, Nishi H, Sekiya N, et al. Atrial fibrillation following aortic valve replacement: impact of perioperative use of intravenous β-blocker. Gen Thorac Cardiovasc Surg. 2017; 65: 194-9.
19. Filardo G, Hamilton C, Hamman B, et al. New-onset postoperative atrial fibrillation and long-term survival after aortic valve replacement surgery. Ann Thorac Surg. 2010; 90: 474-80.
20. Banach, M, Goch A, Misztal M, et al. Predictors of paroxysmal atrial fibrillation in patients undergoing aortic valve replacement. J Thorac Cardiovasc Surg. 2007; 134: 1569-76.
21. Kaireviciute D, Aidietis A, Lip G YH, et al. Atrial fibrillation following cardiac surgery: clinical features and preventative strategies. Eur Heart J. 2009; 30: 410-25.
22. Kalman JM, Munawar M, Howes LG, et al. Atrial fibrillation after coronary artery bypass grafting is associated with sympathetic activation. Ann Thorac Surg. 1995; 60: 1709-15.
23. Sakamoto A, Hamasaki T, Kitakaze M. Perioperative landiolol administration reduces atrial fibrillation after cardiac surgery: A meta-analysis of randomized controlled trials. Adv Ther. 2014; 31: 440-50.
24. Shahim B, Malaisrie C, George I, et al. Postoperative atrial fibrillation or flutter following transcatheter or surgical aortic valve replacement. J Am Coll Cardiol Intv. 2021; 14: 1565-74.
25. Okamura H, Arakawa M, Miyagawa A, Adachi H. Incidence of postoperative atrial fibrillation in transdermal beta-blocker patch users is lower than that in oral beta-blocker users after cardiac and/or thoracic aortic surgery. Gen Thorac Cardiovasc Surg. 2019; 67: 1007-13.