Landiolol hydrochloride for early postoperative tachycardia after transthoracic esophagectomy

To validate the safety and efficacy of landiolol, a beta1-selective blocker, as a primary care option for postoperative tachycardia after transthoracic esophagectomy.

The subjects were 74 consecutive patients who underwent esophagectomy between May 2008 and December 2009. Patients who developed tachycardia with a heart rate >120 bpm for >5 min were defined as candidates for the use of landiolol. The rate of successful heart control without adverse effects was the primary endpoint. The reduction of the rate pressure product (RPP) and heart rate were used as secondary endpoints.

Thirteen patients (18 %) were treated with landiolol for postoperative tachycardia. No adverse effects were observed. Successful management using landiolol alone was achieved in 10 of the 13 patients (77 %). Of the three patients for whom landiolol treatment was unsuccessful, two were also not successfully managed promptly by other treatments. The heart rate and RPP were reduced by landiolol, with median changes of 38 and 44 %, respectively, without significant negative inotropic effects.

Although our sample size was small, an improved cardiac performance and no severe negative inotropic effects were observed with the use of landiolol. Landiolol could therefore be an efficient and safe choice for the management of postoperative tachycardia after esophagectomy.