Abstract
Postoperative atrial fibrillation (PAF) is a common complication after esophagectomy that is associated with prolonged ICU and hospital stays as well as increased costs. Therefore, various types of prophylaxis and treatments for PAF have been investigated. We retrospectively evaluated hemodynamic effects of short-acting β1 selective blocker, landiolol, on persistent PAF in 7 patients after esophagectomy. All patients were males aged 51–87 years. They were refractory to conventional antiarrhythmic therapies. Landiolol was thus infused at rates ranging from 4.3μg/kg/min to 33.5μg/kg/min. Average heart rate (HR) was significantly decreased 1 hour later from 153 [140, 167] [95% confidence intervals] /min to 101 [88, 116] /min (P < 0.0001). Mean arterial pressure remained stable throughout the infusion (88 [78, 94] mmHg to 82 [74, 89] mmHg; P = 0.37) and none of the patients developed hypotension that was severe enough to stop the landiolol infusion. The PAF was converted to sinus rhythm within 24 hours after landiolol administration in 6 patients. Even at low infused doses, landiolol effectively controlled HR in patients with persistent PAF after esophagectomy without severe hypotension.
