Randomized clinical trial of landiolol hydrochloride for the prevention of atrial fibrillation and postoperative complications after oesophagectomy for cancer

@article{Ojima2017RandomizedCT,
  title={Randomized clinical trial of landiolol hydrochloride for the prevention of atrial fibrillation and postoperative complications after oesophagectomy for cancer},
  author={Toshiyasu Ojima and Mikihito Nakamori and M Nakamura and Masahiro Katsuda and Keiji Hayata and T Kato and Junya Kitadani and Hirotaka Tabata and Akihiro Takeuchi and Hiroki Yamaue},
  journal={British Journal of Surgery},
  year={2017},
  volume={104}
}
Atrial fibrillation is common after oesophageal surgery. The aim of this study was to evaluate whether landiolol hydrochloride was effective and safe in the prevention of atrial fibrillation after oesophagectomy, and to see whether a reduction in incidence of atrial fibrillation would reduce other postoperative complications. 

Meta‐analysis of risk factors and complications associated with atrial fibrillation after oesophagectomy

Oesophagectomy is associated with high morbidity and mortality rates. New‐onset atrial fibrillation (AF) is a frequent complication following oesophagectomy. Several studies have explored whether

Landiolol hydrochloride for prevention of atrial fibrillation during esophagectomy: a randomized controlled trial

TLDR
Although the small sample size prevents definitive conclusions, landiolol might not reduce the occurrence of AF or other complications, and this single-center, randomized, double-blind, parallel-group study enrolled patients scheduled for esophagectomy.

Landiolol for managing post-operative atrial fibrillation

TLDR
Landiolol prophylaxis is associated with reduced incidence of post-operative atrial fibrillation without triggering adverse events related to a beta-blockade.

Beta-Blocker Landiolol Hydrochloride in Preventing Atrial Fibrillation Following Cardiothoracic Surgery: A Systematic Review and Meta-Analysis

  • Jianqi HaoJian Zhou Lunxu Liu
  • Medicine
    Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
  • 2021
TLDR
Considering this analysis, landiolol was effective in the prevention of AF after cardiothoracic surgery and did not increase the risk of major postoperative complications.

New-onset atrial fibrillation after esophagectomy for cancer.

TLDR
New-onset atrial fibrillation (AF) after esophagectomy for cancer is frequently observed, and may be related to other postoperative complications, and the influence of AF on postoperative outcomes after esophileal cancer is discussed.

Diltiazem Prophylaxis for the Prevention of Atrial Fibrillation in Patients Undergoing Thoracoabdominal Esophagectomy: A Retrospective Cohort Study

TLDR
A prophylactic 14-day postoperative course of diltiazem was not associated with a reduction in new-onset atrial fibrillation or 30-day mortality following thoracoabdominal esophagectomy and was associated with drug-related adverse effects such as bradycardia and increased requirement of norepinephrine.

Postoperative atrial fibrillation does not impact on overall survival after esophagectomy in patients with thoracic esophageal cancer: results from a randomized, double-blind, placebo-controlled trial

TLDR
New-onset AF and the other severe complications were not associated with poorer long-term survival following esophagectomy, and administration of landiolol hydrochloride after esophageal cancer did not contribute to prolonging the OS.

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS).

2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)

Postoperative atrial fibrillation in thoracic surgery

TLDR
POAF epidemiology, risk factors, prophy-laxes, and treatments mainly for pulmonary resection, esophagectomy, and lung transplantation are discussed, and medical prophylactic agents may effectively reduce POAF.

References

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Landiolol Hydrochloride for Prevention of Atrial Fibrillation after Cardiac Surgery: A Meta‐Analysis

TLDR
A meta‐analysis is conducted to determine whether landiolol is effective in preventing new‐onset AF after cardiac surgery.

Prevention of atrial fibrillation with ultra-low dose landiolol after off-pump coronary artery bypass grafting.

TLDR
Ultra-low dose landiolol is effective for preventing AF after CABG without worsening hemodynamics and no factor emerged as a significant risk factor for postoperative AF.

Effect of landiolol hydrochloride on tachyarrhythmia after esophagectomy.

TLDR
Landiolol hydrochloride can be effectively and safely used in patients who develop tachyarrhythmia after transthoracic esophagectomy, and is seen significantly more frequent in the landiolol group than in the control group.

Atrial fibrillation after esophageal cancer surgery: an analysis of 207 consecutive patients

TLDR
Postoperative AF is associated with the use of a colon conduit for reconstruction after esophagectomy and with tachycardia with a heart rate >100 bpm on postoperative day (POD) 1.

Efficacy of landiolol hydrochloride for prevention of atrial fibrillation after heart valve surgery.

TLDR
It is suggested that landiolol is a useful drug for prevention of atrial fibrillation after valve surgery.

Landiolol hydrochloride for early postoperative tachycardia after transthoracic esophagectomy

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

Association between Postoperatively Developed Atrial Fibrillation and Long-Term Mortality after Esophagectomy in Esophageal Cancer Patients: An Observational Study

TLDR
In esophageal cancer patients, the advanced age and the preoperative medications (CCB, ACEI or ARB) were associated with the incidence of AF, suggesting that a close surveillance might be required in patients who showed AF during postoperative period.