Arita Yoh, Segawa Takatsugu, Yamamoto Shohei, Hasegawa Shinji
Department of Cardiology, Japan Community Healthcare Organization (JCHO), Osaka Hospital, Osaka, Japan.
BMJ Case Rep. 2017 Nov 1;2017:bcr-2017-222268. doi: 10.1136/bcr-2017-222268.
Septic shock is a life-threatening condition that occurs when the blood pressure drops to a low level after an infection. Atrial fibrillation (AF) is the most common arrhythmia to complicate its course. Beta (β)-blockers are often administrated to manage supraventricular tachyarrhythmias observed in patients presenting with sepsis. A 74-year-old woman presenting with sepsis demonstrated AF tachycardia characterised by severe hypotension. She was refractory to conventional therapy including verapamil and digoxin; therefore, treatment using landiolol (an ultrashort-acting β-blocker) was initiated. Her clinical course was followed over 48 hours, and she showed a significant improvement in her heart rate and blood pressure without any adverse effect. Landiolol can rapidly control the accelerated heart rate associated with AF in critically decompensated patients presenting with septic shock.
感染性休克是一种危及生命的病症,发生于感染后血压降至较低水平时。心房颤动(AF)是使其病情复杂化的最常见心律失常。β受体阻滞剂常用于治疗脓毒症患者出现的室上性快速心律失常。一名74岁脓毒症女性表现为以严重低血压为特征的房颤心动过速。她对包括维拉帕米和地高辛在内的传统治疗无效;因此,开始使用兰地洛尔(一种超短效β受体阻滞剂)进行治疗。对她的临床病程进行了48小时的跟踪,结果显示她的心率和血压有显著改善,且无任何不良反应。兰地洛尔可迅速控制感染性休克严重失代偿患者伴有房颤的加速心率。