Switching therapy from intravenous beta blocker to bisoprolol transdermal patch for atrial fibrillation tachycardia.
Beta-blockers are important for severe-status patients with atrial fibrillation-related tachycardia. Beta 1-selective intravenous injection are routinely used, but long-term administration is difficult due to cost-performance- or management-related issues. A bisoprolol patch, a beta-blocker to be percutaneously absorbed, recently became commercially available in Japan. As it may facilitate effective absorption and a mild elevation of the blood concentration, we retrospectively analyzed 16 patients with atrial fibrillation-related tachycardia who were admitted to the Intensive Care Unit of Hitachi General Hospital Emergency and Critical Care Center, and underwent switching therapy from landiolol to a bisoprolol patch. For switching, the bisoprolol patch (4 mg) was attached to each patient. The bisoprolol patch was introduced 88 h after the start of landiolol administration, when the rate was approximately 3 μg/kg/min. Landiolol injection was combined with bisoprolol for 15.4 ± 17.5 h. Switching therapy was successful in all subjects. The introduction of the bisoprolol patch did not induce any significant changes in the blood pressure or heart rate. After the completion of landiolol administration, there were also no significant changes in either parameter. There were no adverse events. In severe-status patients, switching therapy from landiolol injection to the bisoprolol patch can be conducted safely, and might be useful for heart-rate control.
Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1 Jonantyo, Hitachi, Ibaraki, 317-0077, Japan. mamashockpapashock@yahoo.co.jp.
Kensuke
K
Nakamura
Department of Emergency and General Medicine, JR General Hospital, 2-1-3 Yoyogi, Sibuya-ku, Tokyo, 151-8528, Japan.
Ryota
R
Inokuchi
Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo Bunkyo, Tokyo, 113-8655, Japan.
Takahiro
T
Hiruma
Department of Emergency and Critical Care Medicine, Hitachi General Hospital, 2-1-1 Jonantyo, Hitachi, Ibaraki, 317-0077, Japan.
Kurato
K
Tokunaga
Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo Bunkyo, Tokyo, 113-8655, Japan.
Kent
K
Doi
Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, 7-3-1 Hongo Bunkyo, Tokyo, 113-8655, Japan.
Susumu
S
Nakajima
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy*; D017298:Bisoprolol / Q000008:administration & dosage* / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003422:Critical Care; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D057968:Transdermal Patch; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D009025:Morpholines; C077049:landiolol; D014508:Urea; D017298:Bisoprolol
Atrial fibrillation; Beta blocker; Bisoprolol; Critical care; Landiolol