• Hiroki Aoyama, Yuji Otsuka, and Yuka Aoyama.
• Department of Anesthesia, Iwate Prefectural Isawa Hospital, 61 Ryugababa, Mizusawa-ku, Oshu, 023-0864, Japan. hirokiaoyama1975@yahoo.co.jp.
• Gen Thorac Cardiovasc Surg. 2016 Dec 1; 64 (12): 735-741.

ObjectiveWe aimed to determine whether intraoperative low-dose infusion of landiolol, an ultra-short-acting beta blocker, can prevent postoperative atrial fibrillation (POAF) after lung resection.MethodsA double-blind, randomized, controlled, preliminary study was performed in university academic hospital, single center. Fifty lung surgical patients were key-opened before enrollment of the originally planned 100 patients, who were randomized in a 1:1 ratio in each treatment arm. Landiolol was infused with a dosage of 5 μg/kg/min during general anesthesia in the landiolol group, which was compared with the placebo control group with no landiolol. Atrial fibrillation (AF)-free survival curves were generated by means of Kaplan-Meier estimates and differences in survival were compared with the use of the log-rank test. We examined independent predictors of POAF by the multivariate logistic regression analysis using the perioperative parameters detected with the univariate analysis.ResultsThe AF events were recorded for 7 days with Holter monitor in 5 of 25 patients in the landiolol group and 4 of 25 patients in the control group. Kaplan-Meier analysis showed that the landiolol group could not avoid the incidence of POAF in comparison with the placebo saline group (P = 0.806). The multivariate logistic regression analysis for prevalence of POAF identified only one statistically significant predictor: interleukin-6 (IL-6) sampled at 6 h after end of surgery.ConclusionsWe failed to demonstrate that low-dose infusion of landiolol during general anesthesia could prevent the incidence of AF after lung resection. Only IL-6 sampled at 6 h after end of surgery significantly predicted POAF among pulmonary surgical patients.

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