Advertisement

General Thoracic and Cardiovascular Surgery

, Volume 61, Issue 6, pp 350–352 | Cite as

Landiolol for junctional ectopic tachycardia refractory to amiodarone after pediatric cardiac surgery

  • Tomomi HasegawaEmail author
  • Yoshihiro Oshima
  • Ayako Maruo
  • Hironori Matsuhisa
  • Tasuku Kadowaki
  • Rei Noda
Case Report

Abstract

Postoperative junctional ectopic tachycardia (JET) in children undergoing cardiac surgery is a serious arrhythmia that is associated with considerable morbidity and mortality. We present here a case of successful landiolol therapy for postoperative JET in a 3-month-old infant who underwent ventricular septal defect closure and right pulmonary artery plasty. His left ventricular function was poor postoperatively. The JET was refractory to amiodarone and caused severe hypotension, which was required cardiac massage. Continuous intravenous infusion of low-dose landiolol reduced the persistent JET rate immediately, and restored to sinus rhythm with stable hemodynamics.

Keywords

Landiolol Junctional ectopic tachycardia Pediatric cardiac surgery 

References

  1. 1.
    Dodge-Khatami A, Miller OI, Anderson RH, Gil-Jaurena JM, Goldman AP, de Leval MR. Impact of junctional ectopic tachycardia on postoperative morbidity following repair of congenital heart defects. Eur J Cardiothorac Surg. 2002;21(2):255–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Hoffman TM, Bush DM, Wernovsky G, Cohen MI, Wieand TS, Gaynor JW, et al. Postoperative junctional ectopic tachycardia in children: incidence, risk factors, and treatment. Ann Thorac Surg. 2002;74(5):1607–11.PubMedCrossRefGoogle Scholar
  3. 3.
    Kovacikova L, Hakacova N, Dobos D, Skrak P, Zahorec M. Amiodarone as a first-line therapy for postoperative junctional ectopic tachycardia. Ann Thorac Surg. 2009;88(2):616–22.PubMedCrossRefGoogle Scholar
  4. 4.
    Plumpton K, Justo R, Haas N. Amiodarone for post-operative junctional ectopic tachycardia. Cardiol Young. 2005;15(1):13–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Sezai A, Minami K, Nakai T, Hata M, Yoshitake I, Wakui S, et al. Landiolol hydrochloride for prevention of atrial fibrillation after coronary artery bypass grafting: new evidence from the PASCAL trial. J Thorac Cardiovasc Surg. 2011;141(6):1478–87.PubMedCrossRefGoogle Scholar
  6. 6.
    Wariishi S, Yamashita K, Nishimori H, Fukutomi T, Yamamoto M, Radhakrishnan G, et al. Postoperative administration of landiolol hydrochloride for patients with supraventricular arrhythmia: the efficacy of sustained intravenous infusion at a low dose. Interact Cardiovasc Thorac Surg. 2009;9(5):811–3.PubMedCrossRefGoogle Scholar
  7. 7.
    Atarashi H, Kuruma A, Yashima M, Saitoh H, Ino T, Endoh Y, et al. Pharmacokinetics of landiolol hydrochloride, a new ultra-short-acting beta-blocker, in patients with cardiac arrhythmias. Clin Pharmacol Ther. 2000;68(2):143–50.PubMedCrossRefGoogle Scholar
  8. 8.
    Iguchi S, Iwamura H, Nishizaki M, Hayashi A, Senokuchi K, Kobayashi K, et al. Development of a highly cardioselective ultra short-acting beta-blocker, ONO-1101. Chem Pharm Bull (Tokyo). 1992;40(6):1462–9.CrossRefGoogle Scholar
  9. 9.
    Goto K, Shingu C, Miyamoto S, Miyakawa H, Noguchi T. The effect of landiolol on hemodynamics and left ventricular function in patients with coronary artery disease. J Clin Anesth. 2007;19(7):523–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Etheridge SP, Craig JE, Compton SJ. Amiodarone is safe and highly effective therapy for supraventricular tachycardia in infants. Am Heart J. 2001;141(1):105–10.PubMedCrossRefGoogle Scholar
  11. 11.
    Haas NA, Camphausen CK. Impact of early and standardized treatment with amiodarone on therapeutic success and outcome in pediatric patients with postoperative tachyarrhythmia. J Thorac Cardiovasc Surg. 2008;136(5):1215–22.PubMedCrossRefGoogle Scholar
  12. 12.
    Sasao J, Tarver SD, Kindscher JD, Taneyama C, Benson KT, Goto H. In rabbits, landiolol, a new ultra-short-acting beta-blocker, exerts a more potent negative chronotropic effect and less effect on blood pressure than esmolol. Can J Anaesth. 2001;48(10):985–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Fujiwara H, Sakurai M, Namai A, Kawamura T. Effect of low-dose landiolol, an ultrashort-acting beta-blocker, on postoperative atrial fibrillation after CABG surgery. Gen Thorac Cardiovasc Surg. 2009;57(3):132–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Mee RB. Surgical substrates of postoperative junctional ectopic tachycardia in congenital heart defects. J Thorac Cardiovasc Surg. 2002;123(4):615–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Mildh L, Hiippala A, Rautiainen P, Pettila V, Sairanen H, Happonen JM. Junctional ectopic tachycardia after surgery for congenital heart disease: incidence, risk factors and outcome. Eur J Cardiothorac Surg. 2011;39(1):75–80.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2012

Authors and Affiliations

  • Tomomi Hasegawa
    • 1
    Email author
  • Yoshihiro Oshima
    • 1
  • Ayako Maruo
    • 1
  • Hironori Matsuhisa
    • 1
  • Tasuku Kadowaki
    • 1
  • Rei Noda
    • 1
  1. 1.Department of Cardiovascular SurgeryKobe Children’s HospitalKobeJapan

Personalised recommendations