title: Landiolol in the treatment of the intraoperative supraventricular tachycardia: a multicenter, randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  Supraventricular tachycardia during the induction of anesthesia may carry a higher risk.
  
  
  OBJECTIVE
  The aim of this study was to evaluate efficacy and safety of intravenous landiolol in Chinese patients with intraoperative supraventricular tachycardia during anesthesia.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled, parallel-group, multicenter, phase 2 study.
  
  
  METHODS
  Eight sites of Chinese hospitals.
  
  
  METHODS
  Men and women aged 18 to 70 years with the intraoperative supraventricular tachycardia (heart rate [HR], ≥100 beats/min) or the supraventricular tachycardia outside of the sinus tachycardia lasting more than 1 minute.
  
  
  METHODS
  Patients received landiolol or placebo-0.125 mg kg(-1) min(-1) (1 minute) loading→0.04 mg kg(-1) min(-1) (10 minutes) continuous.
  
  
  METHODS
  The proportion of patients receiving rescue medication (esmolol) when the reduction of HR did not exceed 10% after intravenous landiolol for 5 minutes. Other secondary efficacy end points include HR, blood pressure, rate pressure product, and electrocardiogram; the improvement of supraventricular tachycardia; the time it takes for the decrease of the HR to reach more than 10%; and the time it takes for the HR to reach <100 beats/min.
  
  
  RESULTS
  Efficacy and safety were evaluated for 240 patients who received study drug. Lower proportions of patients received rescue medication in the landiolol group (7.63%) compared with that in the placebo group (80.33%) (P < .0001). Suppression of HR and rate pressure product was generally more potent(P < .0001), and higher proportions of patients improved supraventricular tachycardia (P < .0001) in the landiolol group. The most frequent adverse event was hypotension.
  
  
  CONCLUSIONS
  Intravenous landiolol (loading dose of 0.125 mg/kg) may effectively control intraoperative supraventricular tachycardia during anesthesia. It inhibited the increases in HR during the induction of anesthesia. The effect of landiolol on blood pressure was minimal without decreasing diastolic blood pressure and with the minor reduction of systolic blood pressure (ClinicalTrials.gov number, ChiCTR-TRC-12003021).
authors.affiliation: Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: He
authors.affiliation: Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Qiaoqun
authors.initials: Q
authors.lastname: Zou
authors.affiliation: Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Anesthesiology, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Zhanggang
authors.initials: Z
authors.lastname: Xue
authors.affiliation: Department of Anesthesiology, Changhai Hospital of Second Military Medical University, Shanghai, China.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of Anesthesiology, Shanghai First People's Hospital of Shanghai Jiaotong University, Shanghai, China.
authors.forename: Shitong
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, China.
authors.forename: Qunlian
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, Southwest Hospital of Third Military Medical University, Chongqing, China.
authors.forename: Guocai
authors.initials: G
authors.lastname: Tao
authors.affiliation: Department of Anesthesiology, Xinqiao Hospital of Third Military Medical University, Chongqing, China.
authors.forename: Tiande
authors.initials: T
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Sichuan Provincal People's Hospital, Chengdu, China.
authors.forename: Zhixun
authors.initials: Z
authors.lastname: Lang
authors.affiliation: Department of Health Statistics, Second Military Medical University, Shanghai, China.
authors.forename: Jia
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China. Electronic address: xiangruiwang@hotmail.com.
authors.forename: Xiangrui
authors.initials: X
authors.lastname: Wang
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011412:Propanolamines / Q000008:administration & dosage; D013617:Tachycardia, Supraventricular / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D000889:Anti-Arrhythmia Agents; D009025:Morpholines; D011412:Propanolamines; C077049:landiolol; D014508:Urea; C036604:esmolol
keywords: Efficacy; Esmolol; Intraoperative supraventricular tachycardia; Landiolol; Safety