Tsuyoshi Shiga    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Visiting Professor
Language	English
Title	Intravenous Landiolol for Hemodynamically Unstable Ventricular Tachycardia and Ventricular Fibrillation: Outcome of J-Land Study II
Conference	The 83rd Annual Scientific Meeting of the Japanese Circulation Society (JCS2019)
Promoters	Japanese Circulation Society
Conference Type	Nationwide Conferences
Presentation Type	Speech
Lecture Type	General
Publisher and common publisher	◎SHIGA Tsuyoshi, IKEDA Takanori, SHIMIZU Wataru, KINUGAWA Koichiro, SAKAMOTO Atsuhiro, NAGAI Ryozo, DAIMON Takashi, OKI Kaori, OKAMOTO Haruka, YAMASHITA Takeshi, (Discussant) TAKATSUKI Seiji
Date	2019/03/30
Venue (city and name of the country)	Yokohama, JAPAN
Summary	*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.