所属 医学部 医学科（東京女子医科大学病院） 職種 客員教授
|発表タイトル||Intravenous Landiolol for Hemodynamically Unstable Ventricular Tachycardia and Ventricular Fibrillation: Outcome of J-Land Study II|
|会議名||The 83rd Annual Scientific Meeting of the Japanese Circulation Society (JCS2019)|
|主催者||Japanese Circulation Society|
|発表者・共同発表者||◎SHIGA Tsuyoshi, IKEDA Takanori, SHIMIZU Wataru, KINUGAWA Koichiro, SAKAMOTO Atsuhiro, NAGAI Ryozo, DAIMON Takashi, OKI Kaori, OKAMOTO Haruka, YAMASHITA Takeshi, (Discussant) TAKATSUKI Seiji|
|概要||*Late Breaking Clinical Trials 2 Arrhythmias/Lifestyle Diseases
Background: Class III antiarrhythmic drugs such as amiodarone and nifekalant are used first to prevent ventricular tachycardia (VT) or ventricular fibrillation (VF) in most patients. However, VT/VF sometimes shows resistance to these drugs, which is a major problem in emergency medical care. Some clinical studies have demonstrated that βblockers effectively suppress VT/VF, which suggests that enhanced sympathetic nerve activity is involved.
Objective: To evaluate the efficacy and safety of landiolol in Japanese patients with hemodynamically unstable VT or VF.
Design: Prospective, multi-center, open-label, noncomparative study.
Patients and methods: This study group included 29 patients with hemodynamically unstable VT or VF refractory to class III antiarrhythmic drugs, such as amiodarone, nifekalant and sotalol. Continuous intravenous administration of landiolol was started at a dose of 1 µg/kg/min, after VT/VF were stopped with electrical defibrillation, and titrated up to 10 µg/kg/min in 1-hour with monitoring heart rate and blood pressure for 49 - 120 hours. Only if the hemodynamically unstable VT or VF was recurrenced, the dose of landiolol could be increased to 40 µg/kg/min. The primary endpoint was the proportion of patients free from hemodynamically unstable VT or VF during 48-hours of landiolol therapy. Safety was assessed by adverse events including hypotension.
Conclusions: Landiolol is effective and safe for preventing the recurrence of hemodynamically unstable VT or VF, and could be considered as a therapeutic option in this clinical setting.