Abstract
Objectives: Patients with systemic inflammatory response syndrome (SIRS) sometimes demonstrate atrial fibrillation with a rapid ventricular response, which is not easy to control. We examined the effect of landiolol, a short-acting selective β1-adrenergic receptor blocker on paroxysmal atrial fibrillation with a rapid ventricular response caused by SIRS. Methods: Sixteen patients of paroxysmal atrial fibrillation with a rapid ventricular response caused by SIRS were injected with landiolol and the changes in heart rate and blood pressure were recorded. In 9 of 16 patients, hemodynamic parameters including cardiac index were measured. Next, we compared the effects of landiolol, digoxin, cibenzoline, and verapamil for 63 patients with paroxysmal atrial fibrillation and a rapid ventricular response caused by SIRS. All data were from reviewing 3 years of retrospective data. Results: Landiolol certainly decreased the heart rate without inducing a massive decline in blood pressure. Landiolol decreased cardiac index, but increased the stroke volume index. Landiolol decreased the heart rate more than the other drugs. The blood pressure lowering effect of landiolol was comparable to those of cibenzoline and verapamil. The success rate of pharmacological cardioversion using landiolol was higher than that using digoxin or verapamil, and was nearly equal to that using cibenzoline. Conclusions: Landiolol was effective for paroxysmal atrial fibrillation with a rapid ventricular response caused by SIRS.
