title: Prevention of atrial fibrillation with ultra-low dose landiolol after off-pump coronary artery bypass grafting.
abstract: OBJECTIVE
  Postoperative atrial fibrillation (AF) is a common complication of cardiac surgery that is associated with an increased incidence of other complications. The goal of this prospective randomized study was to evaluate the effect of ultra-low dose landiolol hydrochloride for prevention of AF after off-pump coronary artery bypass grafting (CABG).
  
  
  METHODS
  The subjects were 47 patients who underwent isolated CABG and were randomly divided into those who received landiolol from ICU admission until the beginning of oral drug intake (Group L) and those administered diltiazem hydrochloride over the same period (Group D). The incidence of AF within one week after surgery was examined as the primary endpoint. Heart rate, blood pressure, cardiac output, and other hemodynamic parameters were used as secondary endpoints. The rates of adverse events were also recorded.
  
  
  RESULTS
  The incidences of AF in the first postoperative week were 4.8% and 27% in Groups L and D, respectively (p = 0.046). There were no differences in hemodynamic parameters between the Groups. In multivariate analysis, no factor emerged as a significant risk factor for postoperative AF. Two patients had adverse events of asthma and hypotension, respectively, in Group L.
  
  
  CONCLUSIONS
  Ultra-low dose landiolol is effective for preventing AF after CABG without worsening hemodynamics.
authors: Department of Cardiovascular Surgery, Tokyo Medical and Dental University.
authors: Eiki
authors: E
authors: Nagaoka
authors: Hirokuni
authors: H
authors: Arai
authors: Kiyoshi
authors: K
authors: Tamura
authors: Satoru
authors: S
authors: Makita
authors: Naoto
authors: N
authors: Miyagi
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control*; D016009:Chi-Square Distribution; D047549:Coronary Artery Bypass, Off-Pump / Q000009:adverse effects*; D004110:Diltiazem / Q000008:administration & dosage; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage*; D015999:Multivariate Analysis; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D009025:Morpholines; C077049:landiolol; D014508:Urea; D004110:Diltiazem