Landiolol, an Ultra-Short-Acting β₁-Blocker, More Effectively Terminates Atrial Fibrillation Than Diltiazem After Open Heart Surgery

71 patients (from 335 analyzed) aged 20-85 years who developed postoperative atrial fibrillation (AF) after elective open heart surgery. Mean age ~70, ~32% female. Exclusions: acute myocardial infarction within 3 days, history of supraventricular arrhythmia requiring treatment, sinus node disease, permanent pacemaker, severe heart failure (NYHA III/IV or EF <35%), AV block ≥second degree, contraindications to β-blocker or calcium channel blocker, secondary AF causes, hypotension (<90/60 mmHg), and perioperative use of anti-arrhythmic agents other than digitalis.

Landiolol IV continuous infusion at an initial rate of 0.5–2 μg·kg–1·min–1, titrated to a maximum rate of 40 μg·kg–1·min–1 based on hemodynamic/ECG responses, for a duration of 24 hours.

Diltiazem IV bolus dose of 0.25 mg/kg over 2 min, followed by an initial rate of 3 mg/h titrated to a maximum rate of 15 mg/h based on hemodynamic/ECG responses, for a duration of 24 hours.

Frequency of conversion to sinus rhythm after 8 hours of treatment.surrogate