Prevention of immediate recurrence of atrial fibrillation with low-dose landiolol after radiofrequency catheter ablation

• Published in: Journal of arrhythmia Vol. 31; no. 5; pp. 279 - 285
• Main Authors: Ishigaki, Daisuke, M.D, Arimoto, Takanori, M.D, Iwayama, Tadateru, M.D, Hashimoto, Naoaki, M.D, Kutsuzawa, Daisuke, M.D, Kumagai, Yu, M.D, Nishiyama, Satoshi, M.D, Takahashi, Hiroki, M.D, Shishido, Tetsuro, M.D, Miyamoto, Takuya, M.D, Watanabe, Tetsu, M.D, Kubota, Isao, M.D
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.10.2015; Elsevier; Wiley
• Subjects: Ablation; Ablation (Surgery); Antiarrhythmics; Atrial fibrillation; Bepridil; Blood pressure; Body temperature; Cardiac arrhythmia; Cardiovascular; Catheter ablation; Catheters; Comparative analysis; Complications and side effects; Diabetes; Diseases; Drug dosages; Drug resistance; Electrocardiography; Enzymes; Heart beat; Heart rate; Hypertension; Immediate recurrence; Ischemia; Landiolol; Original; Patients; Prevention; Proteins; Radio frequency; Relapse; Transient ischemic attack; United States > US; Japan; Landiolol; Atrial fibrillation; Catheter ablation; Immediate recurrence
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1016/j.joa.2015.02.003

Abstract Background Immediate recurrence of atrial fibrillation (AF) after radiofrequency (RF) catheter ablation is commonly observed within 3 d after the procedure. The mechanism and pharmacological management of immediate AF recurrence remain unclear. Methods A total of 50 consecutive patients with paroxysmal AF were randomized to receive either low-dose landiolol (landiolol group) or a placebo (placebo group). In the landiolol group, intravenous landiolol (0.5 μg kg−1 min−1 ) was administered for 3 d after AF ablation. Results No serious adverse event associated with RF catheter ablation or landiolol administration was observed. The prevalence of immediate AF recurrence (≤3 d after RF catheter ablation) was significantly lower in the landiolol group than in the placebo group (16% vs. 48%, p =0.015). Although the postprocedural change in heart rate was significantly lower in the landiolol group compared to that in the placebo group, the changes in blood pressure and body temperature were not different between the two groups. Multiple logistic regression analysis revealed that landiolol treatment was the only independent predictor of immediate AF recurrence after ablation (odds ratio: 0.180; 95% confidence interval: 0.044–0.729; p =0.016). Conclusions Prophylactic administration of low-dose landiolol after AF ablation may be effective and safe for preventing immediate AF recurrence within 3 d after AF ablation.