Abstract 18612: Intravenous Infusion of Ultrashort-acting Beta-blocker, Landiolol, for Prevention of Immediate Recurrence of Atrial Fibrillation after Catheter Ablation

BACKGROUND: Immediate recurrence of atrial fibrillation (AF) after catheter ablation (CA) troubles with patients. We investigated whether intraveneous infusion of landiolol, an ultrashort-acting beta-blocker, could inhibit immediate AF recurrence after CA by randomized controlled trial. METHOD: atients with drug-resistant AF treated by CA were assigned to receive either landiolol or placebo after the procedure. In the landiolol group, landiolol was infused ntraveneously at speed of 1 μg/kg/min and continued for 3 days after the CA. The primary end point was occurrence/non-occurrence of AF, defined as supra-ventricular arrhythmia more than 5 min, up to 3-day after CA. Logistic regression analysis was performed to investigate risk factor. RESULT: 31 and 24 patients were assigned to landiolol group and placebo group, respectively. There were no significant difference between both groups in systolic blood pressure (SBP) before CA, diastolic blood pressure (DBP) before CA and changes from pre-CA to post-CA of SBP and DBP. AF recurrence occurred in 5 patients (10%) in landiolol group versus 11 patients (45%) in the placebo group (P=0.016, Figure). Multivariable analysis revealed that landiolol infusion significantly reduced the risk of transient AF recurrence after procedure (Hazard ratio: 0.208, 95% confidence interval of hazard ratio: 0.048-0.897, P=0.035). CONCLUSIONS: Short-term landiolol infusion successfully decreased immediate AF recurrence after CA without changing SBP and DBP. Administration of landiolol may become a new strategy to facilitate management after CA.