Key result
Landiolol achieved a reduction in heart rate of ≥20% or termination of tachycardia at 2 hours in 48.0% of pediatric patients with supraventricular tachyarrhythmias and reduced cardiac function.
Why the study?
Does landiolol reduce heart rate or terminate tachycardia in pediatric patients with supraventricular tachyarrhythmias and reduced cardiac function?
Does landiolol reduce heart rate or terminate tachycardia in pediatric patients with supraventricular tachyarrhythmias and reduced cardiac function?
Landiolol effectively reduced heart rate or terminated tachycardia in pediatric patients with supraventricular tachyarrhythmias and reduced cardiac function, though hypotension was a notable adverse reaction.
Hypothesis-generating for landiolol in pediatric SVT with reduced function; prospective trials needed before clinical adoption.
BACKGROUND: selective blocker, in children. METHODS AND RESULTS: Twenty-five inpatients aged ≥3 months to <15 years who developed supraventricular tachyarrhythmias (atrial fibrillation, atrial flutter, supraventricular tachycardia, and inappropriate sinus tachycardia) were treated with landiolol. The primary endpoint, the percent of patients with a reduction in heart rate ≥20% from the initial rate of tachycardia, or termination of tachycardia at 2 h after starting landiolol, was achieved in 12/25 patients (48.0%; 95% CI 28.4-67.6), which exceeded the predetermined threshold (38.0%). At 2 h after starting landiolol administration, heart rate had decreased by ≥20% in 45.8% (11/24) and recovery to sinus rhythm was achieved in 40.0% (6/15) of the patients. Adverse reactions (ARs) occurred in 24.0% (6/25) of patients, and the study was discontinued in 4.0% (1/25) of the patients; however, none of these ARs were considered serious. The most common AR was hypotension (20.0% [5/25] of patients). CONCLUSIONS: The HEARTFUL study has demonstrated the efficacy of landiolol, by reducing heart rate or terminating tachycardia, in pediatric patients with supraventricular tachyarrhythmias. Although serious ARs and concerns were not identified in this study, physicians should be always cautious of circulatory collapse due to hypotension.
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Sagawa et al. (2022) studied Supraventricular tachyarrhythmias with reduced cardiac function (n=25). Landiolol was evaluated on Reduction in heart rate ≥20% from the initial rate of tachycardia, or termination of tachycardia at 2 h after starting landiolol (95% CI 28.4-67.6). Landiolol achieved a reduction in heart rate of ≥20% or termination of tachycardia at 2 hours in 48.0% of pediatric patients with supraventricular tachyarrhythmias and reduced cardiac function.
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