Efficacy and Safety of Landiolol in Heart Failure Patients with Supraventricular Tachycardia Compared to Diltiazem

Objective: Both landiolol and diltiazem are used for controlling heart rate (HR) in heart failure patients with supraventricular tachycardia: atrial fibrillation, atrial flutter and atrial tachycardia. However, it is not clear which is more effective, landiolol or diltiazem. This study aimed to investigate the efficacy and safety of landiolol compared to diltiazem. Methods: We retrospectively collected data of 64 consecutive heart failure patients with supraventricular tachycardia (HR > 110 beat-per-minutes), who were administered landiolol (n = 32) or diltiazem (n = 32) for controlling HR between January 2014 and April 2016. The primary outcome was reduction rate in HR, and the secondary outcome was depression of systolic blood pressure 2 hours after the administration of each drug. Results: The patients' characteristics in landiolol and diltiazem groups were as follows; 69% and 47% were men (N.S.), mean age was 67.3 ± 14.4 and 78.8 ± 12.8 years (P = .0012), ejection fraction were 30.8% and 36.6% (P = .025), and mean HR at baseline were 149.0 ± 24.5 and 133.7 ± 15.2 beats-per-minutes (P = .0039). The primary and secondary outcomes in landiolol and diltiazem groups were as follows; reduction rate in HR at 2 hours after administration were 23.1 ± 17.8% and 14.5 ± 15.7% (P = .044), and depression of systolic blood pressure were 7.5 ± 22.2 and 2.3 ± 17.0 mmHg (N.S.). Conclusions: Landiolol is safe and could be more effective than diltiazem for HR control in heart failure patients with supraventricular tachycardia.