Landiolol hydrochloride infusion for treatment of junctional ectopic tachycardia in post-operative paediatric patients with congenital heart defect.

Abstract

AIMS:

Junctional ectopic tachycardia (JET) after cardiopulmonary bypass surgery for congenital heart defects is often therapy-resistant and associated with high morbidity and mortality. Improvement of pharmacological therapy is needed.

METHODS AND RESULTS:

We retrospectively analysed the clinical data of four patients with congenital heart defects, who developed post-operative JET and were treated with landiolol hydrochloride, representing all such patients treated at our university. In two patients, landiolol was used after failure of response to anti-arrhythmic therapies, including thermal control, sedation, discontinuation of catecholamines, and pharmacological therapy with nifekalant and amiodarone. Landiolol was used as a first-line therapy in the other two patients. In all patients, landiolol, at a dose ranging from 1.0 to 10.0 µg/kg/min, achieved successful sinus conversion within 15 min. No adverse events, such as bradycardia, hypotension, or hypoglycaemia, were encountered in all four patients.

CONCLUSION:

Although limited to a small and heterogeneous group of patients, the results suggest that landiolol is a potentially useful therapeutic option for the well-known difficult condition of post-operative JET, and warrant further investigation in large-scale controlled studies.

• Authors: Hirofumi Saiki, Ryo Nakagawa, Hirotaka Ishido, Satoshi Masutani, Hideaki Senzaki
• Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (Europace) Vol. 15 Issue 9 Pg. 1298-303 (Sep 2013) ISSN: 1532-2092 [Electronic] England
• PMID: 23471432 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Morpholines
• landiolol
• Urea

Topics

• Anti-Arrhythmia Agents (administration & dosage)
• Cardiopulmonary Bypass (adverse effects)
• Heart Defects, Congenital (complications, surgery)
• Humans
• Infant
• Infusions, Intravenous
• Male
• Morpholines (administration & dosage)
• Postoperative Care
• Retrospective Studies
• Tachycardia, Ectopic Junctional (drug therapy, etiology, prevention & control)
• Treatment Outcome
• Urea (administration & dosage, analogs & derivatives)