[Successful control of rapid heart rate in a patient with atrial fibrillation by continuous intravenous administration of landiolol hydrochloride].
A 79-year-old man with atrial fibrillation underwent total pharyngolaryngectomy and free flap reconstruction for hypolaryngeal cancer under general anesthesia. He developed tachyarrhythmia with ST depression and inverted T wave. The treatment including sufficient fluid therapy, continuous administration of vasodilator and intravenous digoxin failed to control the abnormalities. Then landiolol hydrochloride, a new cardioselective ultra-short acting beta-blocker, was continuously administered. Despite the relatively low doses with 1 min loading infusion at 0.04 mg.kg-1.min-1 and continuous infusion at 0.016 mg.kg1.min-1, rapid control of heart rate occurred in a few minutes and inverted T waves were normalized in fifteen minutes. There was no significant change of peripheral blood pressure. The present case suggests that landiolol hydrochloride is effective in controlling heart rate in a patient with atrial fibrillation and that the optimal dose should be carefully evaluated for each case.
Konishi
Ruriko
R
Department of Anesthesiology and Critical Care Medicine, Jichi Medical School, Tochigi 329-0334.
Maeda
Ryoko
R
Endo
Izumi
I
Inoue
Nanae
N
Seo
Norimasa
N
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000150:complications*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009025:Morpholines / Q000008:administration & dosage*; D013610:Tachycardia / Q000188:drug therapy* / Q000209:etiology; D014508:Urea / Q000008:administration & dosage* / Q000031:analogs & derivatives*
D000889:Anti-Arrhythmia Agents; D009025:Morpholines; C077049:landiolol; D014508:Urea