著者

Tokunaga Chiho Hiramatsu Yuji Kanemoto Shinya Takahashi-Igari Miho Abe Masakazu Horigome Hitoshi Sakakibara Yuzuru

出版者

Elsevier Inc.

雑誌

The annals of thoracic surgery (ISSN:00034975)

巻号頁・発行日

vol.95, no.5, pp.1685-1688, 2013-05

被引用文献数

13

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BackgroundWhile β-blockers can be effective in controlling tachyarrhythmias after pediatric cardiac surgery, a negative inotropic influence sometimes complicates their use. Landiolol hydrochloride is a novel, ultra-short-acting β-blocker recently developed in Japan. The drug has higher β1:β2 selectivity ratio and a less negative inotropic effect. This study retrospectively evaluates the efficacy and safety of landiolol in the management of tachyarrhythmias after pediatric cardiac surgery.MethodsA retrospective analysis was performed on 312 consecutive patients undergoing surgery for congenital heart disease. Twelve patients were treated with landiolol for critical tachyarrhythmia. The mean age of patients was 28.7 ± 10.6 months. Five junctional ectopic tachycardia, 2 atrial flutters, 1 paroxysmal supraventricular tachycardia, 1 atrial fibrillation, 1 atrioventricular reciprocating tachycardia with Wolff-Parkinson-White syndrome and 2 excessive sinus tachycardia were treated.ResultsThe mean loading and maintenance doses were 11.3 ± 4.0 and 6.8 ± 0.9 μg/kg per minute, respectively. Rate control was achieved in all patients. Landiolol reduced the heart rate from 169.7 ± 11.4 to 127.7 ± 7.5 beats per minute (p < 0.05) while blood pressure did not significantly change. Tachyarrhythmias were converted to sinus rhythm in 70.0% of the cases and the average time needed to achieve heart rate reduction was 2.3 ± 0.5 hours.ConclusionsLandiolol was efficacious in treating tachyarrhythmia in pediatric cardiac surgery. The desired negative chronotropic effect was achieved without significant hemodynamic compromise. The ultra-short half-life of landiolol provided rapid dose manipulation. This study suggests that landiolol is a promising option for the management of postoperative tachyarrhythmias in pediatric patients.

著者

Seki Yusuke Kandori Akihiko Kumagai Yukio Ohnuma Mitsuru Ishiyama Akihiko Ishii Tetsuko Nakamura Yoshiyuki Horigome Hitoshi Chiba Toshio

出版者

American Institute of Physics

雑誌

Review of scientific instruments (ISSN:00346748)

巻号頁・発行日

vol.79, no.3, pp.036106, 2008-03

被引用文献数

11 14

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We developed a fetal magnetocardiography (fMCG) system that uses a pair of two-dimensional gradiometers to achieve high signal-to-noise ratio. The gradiometer, which is based on a low-Tc superconducting quantum interference device, detects the gradient of a magnetic field in two orthogonal directions. Gradiometer position is easy to adjust by operating the gantry to drive the cryostat in both the swinging and axial directions. As a result, a fMCG waveform for 25 weeks' gestation was measured under an unshielded environment in real time. Moreover, the P and T waves for 25 and 34 weeks' gestation, respectively, were obtained by averaging. These results indicate that this two-dimensional gradiometer is one of the most promising techniques for measuring fetal heart rate and diagnosing fetal arrhythmia.