Key result
IV landiolol increases target heart rate achievement ~5-fold vs alternatives in SVT with LV dysfunction.
Why the study?
To explore the effects of landiolol administration in individuals presenting with SVT and concurrent left ventricular dysfunction who are non-septic and not in a peri-operative period.
Does intravenous landiolol improve rate control in patients with supraventricular tachyarrhythmias and left ventricular dysfunction compared to alternative antiarrhythmic therapy?
Meta-Analysis
Does intravenous landiolol improve rate control in patients with supraventricular tachyarrhythmias and left ventricular dysfunction compared to alternative antiarrhythmic therapy?
Intravenous landiolol effectively reduces heart rate and achieves target HR in patients with SVT and left ventricular dysfunction without significantly increasing adverse events compared to alternative therapies.
Answers are grounded in this paper and cite their sources.
Supports landiolol for rate control in SVT with LV dysfunction; extends pooled evidence from prior studies.
Background: This systematic review explores the effects of landiolol administration in individuals presenting with supraventricular tachyarrhythmia (SVT) and concurrent left ventricular dysfunction, without being septic or in a peri-operative period. Methods: We systematically searched PubMed, Cochrane, Web of Science, and Scopus databases, retrieving a total of 15 eligible studies according to prespecified eligibility criteria. Results: Patients treated with landiolol experienced a substantial reduction in heart rate (HR) (mean HR reduction: 42 bpm, 95% confidence intervals (CIs): 37–47, I2 = 82%) and were more likely to achieve the target HR compared to those receiving alternative antiarrhythmic therapy (pooled odds ratio (OR): 5.37, 95% CIs: 2.87–10.05, I2 = 0%). Adverse events, primarily hypotension, occurred in 14.7% of patients receiving landiolol, but no significant difference was observed between the landiolol and alternative antiarrhythmic receiving groups (pooled OR: 1.02, 95% CI: 0.57–1.83, I2 = 0%). No significant difference was observed between the two groups concerning sinus rhythm restoration (pooled OR: 0.97, 95% CI: 0.25–3.78, I2 = 0%) and drug discontinuation due to adverse events (pooled OR: 5.09, 95% CI: 0.6–43.38, I2 = 0%). Conclusion: While further research is warranted, this systematic review highlights the potential benefits of landiolol administration in the management of SVTs in the context of left ventricular dysfunction.
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Nasoufidou et al. (2024) conducted a meta-analysis in Supraventricular tachyarrhythmia with concurrent left ventricular dysfunction. Intravenous Landiolol vs. Alternative antiarrhythmic therapy was evaluated on Achieving target heart rate (OR 5.37, 95% CI 2.87-10.05). Intravenous landiolol increased the likelihood of achieving target heart rate compared to alternative antiarrhythmics in SVT with LV dysfunction (OR 5.37; 95% CI 2.87-10.05).
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