Sakaguchi Masanori, Sasaki Yasuyuki, Hirai Hidekazu, Hosono Mitsuharu, Nakahira Atsushi, Seo Hiroyuki, Suehiro Shigefumi
Department of Cardiovascular Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Int Heart J. 2012;53(6):359-63. doi: 10.1536/ihj.53.359.
The goal of this prospective study was to examine the effects of landiolol hydrochloride on prevention of atrial fibrillation and on hemodynamics in the acute postoperative phase after heart valve surgery. The subjects were 60 patients who underwent valve surgery at our hospital from April 2008 to July 2010. The patients were randomly divided into two groups: the landiolol group (30 patients) and the control (no landiolol) group (30 patients). In the landiolol group, continuous intravenous landiolol was initiated immediately on admission to the intensive care unit at a dose of 10 µg/kg/ minute. Occurrence of atrial fibrillation was compared between the groups over an observation period of 72 hours after surgery. Atrial fibrillation occurred in 6 patients (20%) in the landiolol group and 16 (53.3%) in the control group during the observation period. Landiolol hydrochloride significantly reduced the occurrence of atrial fibrillation in the acute postoperative phase after heart valve surgery. Heart rate was significantly decreased by landiolol, but aggravation of hemodynamics was not observed. These results suggest that landiolol is a useful drug for prevention of atrial fibrillation after valve surgery.
本前瞻性研究的目的是探讨盐酸兰地洛尔对心脏瓣膜手术后急性术后阶段心房颤动的预防作用及对血流动力学的影响。研究对象为2008年4月至2010年7月在我院接受瓣膜手术的60例患者。患者被随机分为两组:兰地洛尔组(30例患者)和对照组(未使用兰地洛尔,30例患者)。在兰地洛尔组中,患者入住重症监护病房后立即开始静脉持续输注兰地洛尔,剂量为10μg/kg/分钟。比较两组患者术后72小时观察期内心房颤动的发生情况。观察期内,兰地洛尔组有6例患者(20%)发生心房颤动,对照组有16例患者(53.3%)发生心房颤动。盐酸兰地洛尔显著降低了心脏瓣膜手术后急性术后阶段心房颤动的发生率。兰地洛尔使心率显著降低,但未观察到血流动力学恶化。这些结果表明,兰地洛尔是预防瓣膜手术后心房颤动的有效药物。