Juraj Dúbrava
Landiolol is an intravenous beta-blocker available in Europe since 2016. Compared to other intravenous beta-blockers
it has several specific properties: fast onset of the effect , very short biological half-time (4 minutes), ultra-short
duration of the effect (within 15 minutes after the end of administration). Therefore, it is sometimes referred to as
an „on-off“ beta-blocker. It has the highest β1/β2 selectivity and a strong heart-rate lowering effect. Two unique characteristics
are highly advantageous in clinical practice – a limited negative inotropic effect and a minimal influence
on blood pressure. These properties are significantly different from intravenous metoprolol and esmolol. The specific
profile allows administration also in patients with left ventricular dysfunction, acute heart failure, or in patients
prone to hypotension. Landiolol is indicated for rapid heart rate control in patients with atrial fibrillation, atrial flutter
or non-compensatory sinus tachycardia in the perioperative and post-operative periods and in other emergencies
in intensive care. In the overview article we present the evidence-based medicine for landiolol in cardiac and
non-cardiac surgery, intensive medicine, left ventricular dysfunction and other indications.