Effects of Landiolol, an Ultra-Short-Acting β₁-Selective Blocker, on Electrical Storm Refractory to Class III Antiarrhythmic Drugs

摘要

Background: ?Occasionally it is difficult to inhibit electrical storm (ES) with standard pharmacological treatment. In the present study the effect of landiolol, an ultra-short-acting β₁-selective blocker, on ES refractory to class III antiarrhythmic drugs was evaluated. Methods and Results: ?The study group comprised 42 consecutive patients who developed ES for which intravenous class III antiarrhythmic drugs, such as amiodarone and nifekalant, were ineffective. Landiolol was administered intravenously with an initial dose of 2.5?μg?·?kg–1?·?min–1, which was doubled if it was ineffective, up to a maximum dose of 80?μg?·?kg–1?·?min–1. Landiolol inhibited ES in 33 patients (79%) at a mean dose of 7.5±12.2?μg?·?kg–1?·?min–1. All patients in whom landiolol was ineffective died of arrhythmia. Of the 33 patients in whom landiolol was effective, 25 survived and were discharged (60% of all patients). Landiolol significantly decreased heart rate (P