Landiolol in Postoperative Atrial Fibrillation

Microcirculatory and Macrocirculatory Effects of Landiolol in Prevention of Postoperative Atrial Fibrillation: a Randomized Study.

Postoperative atrial fibrillation is a common complication after cardiac surgery and is associated with an elevation of morbidity and mortality. The recommended treatment includes heart rate control with a beta blocker. Landiolol is a new-generation beta-blocker with favourable pharmacologic properties making an interesting drug to treat postoperative atrial fibrillation. However, Landiolol micro and macrocirculatory effects in the setting of atrial fibrillation are yet to describe. The aim of this study is to describe microcirculatory effects of incremental doses of landiolol in postoperative atrial fibrillation compared to a placebo. Our hypothesis is Landiolol will improve microcirculation disorders.

Inclusion Criteria:

• Patient underwent conventional cardiac surgery
• Age > 18 years
• Writing contentment

Exclusion Criteria:

• Pre-existing chronic atrial fibrillation
• Contraindication to beta-blockers
• Circulatory shock (cardiac index<2.2 L/min and lactate>4mmol/L)
• Distributive shock (cardiac index>2.2 L/min with norepinephrine dose > 0.3 µg/kg/min to reach mean arterial pressure > 65mmHg).
• Acute respiratory distress
• Major bleeding (>200mL/h)
• Patient already included into an interventional clinical study
• Pregnancy
• No social security insurance
• Patient not able to give consent (curators, patients deprived of public rights)