Mitsuaki Tanaka

A Case Developing Acute Heart failure 7 Days Later After Pacemaker Implantation to Asymptomatic Complete Atrioventricular Block

patients with AMI after primary percutaneous coronary intervention (PCI) were randomly assigned to landiolol group (n525) or control group (n523). All patients took oral beta blocker (carvedilol or bisoprolol) after they had left ICU. UCG and brain natriuretic peptide (BNP) were recorded in both groups at 6 months. Tc-MIBI scintigraphy was also performed and these data were analyzed by software, CardioBULL which quantifies infarct size. Result: Left ventricular ejection fraction in landiolol group was better than in control group though there were no significant differences (55.2611.5% vs 59.6611.5%). Infarct size was no significant difference at 6 months (7.569.5% vs 7.0612.9%). BNP level tended to be higher in landiolol group both in the acute phase (65.5670.6pg/ml vs 128.36219.7pg/ml, p50.18) and at the point of discharge (115.3678.1pg/ml vs 152.4699.6pg/ml, p50.25). However, 6 months after the procedure, BNP level in landiolol group was significantly lower than control group (63.1656.3pg/ml vs 40.0627.3pg/ml, p!0.05). Conclusion: Low dose landiolol during very acute phase of AMI improves BNP level in the chronic phase and may result in the reduction of cardiovascular event.