title: Landiolol hydrochloride infusion for treatment of junctional ectopic tachycardia in post-operative paediatric patients with congenital heart defect.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Pediatrics and Pediatric Cardiology, Saitama Medical Center, Saitama Medical University, Staff Office Building 101, 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Saiki
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakagawa
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ishido
authors.forename: Satoshi
authors.initials: S
authors.lastname: Masutani
authors.forename: Hideaki
authors.initials: H
authors.lastname: Senzaki
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D006330:Heart Defects, Congenital / Q000150:complications* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D009025:Morpholines / Q000008:administration & dosage*; D011182:Postoperative Care; D012189:Retrospective Studies; D013613:Tachycardia, Ectopic Junctional / Q000188:drug therapy* / Q000209:etiology* / Q000517:prevention & control; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000889:Anti-Arrhythmia Agents; D009025:Morpholines; C077049:landiolol; D014508:Urea
keywords: Congenital heart disease; Junctional ectopic tachycardia; Landiolol