Effects of landiolol on left ventricular function during electroconvulsive therapy: a transthoracic echocardiographic...

The purpose of this study was to examine the effects of landiolol on left ventricular (LV) systolic function, using transthoracic echocardiography, during electroconvulsive therapy (ECT). Fourteen patients undergoing ECT were studied. Bilateral ECT was performed after administration of thiopentone (2 mg/kg), succinylcholine (1 mg/kg), and initiation of assisted mask ventilation with 100% oxygen. Patients received a bolus injection of landiolol (0.125 mg/kg) or saline immediately after anesthetic induction and prior to electrical shock. LV systolic function was examined by transthoracic echocardiography prior to anesthetic induction, throughout the ECT procedure, and for 10 min after the seizure. Electrical shock resulted in a significant decrease in fractional area change (FAC) when compared with the awake condition in the control group [FAC when awake: 48 +/- 3%; 1 min after ECT: 38 +/- 4%*; 2 min after ECT: 36 +/- 4%*; 3 min after ECT: 40 +/- 3%*; mean +/- standard deviation, *p < 0.05 compared with awake]. Landiolol infusion stabilized systemic hemodynamics and LV systolic function. The study demonstrated that landiolol is a suitable agent to minimize hemodynamic changes and transthoracic echocardiographic variability after ECT.