Usefulness of short-acting β₁ selective blocker (landiolol hydrochloride) for postoperative tachyarrhythmia after radical operation of esophageal cancer

Tachyarrhythmia is a major complication after radical esophageal cancer surgery. We report five such cases in which short-acting β₁ selective blocker (landiolol hydrochloride) successfully improved the abnormal heart rate. Preoperative electrocardiography and echocardiography were normal in all subjects. Tachyarrhythmia occurred on postoperative day (POD) 2 or 3. In the first two cases, landiolol hydrochloride was administered after other antiarrhythmic agents such as digitalis and verapamil failed. It was administered as the initial drug in the last three cases. The landiolol hydrochloride dose was 20μg/kg/min in the first case as a recommendation, and 2μg/kg/min in the others. The heart rate markedly decreased within a few minutes and systolic blood pressure was unchanged during landiolol hydrochloride administration in all cases. The half-life of landiolol hydrochloride is about 3-4 minutes, which makes it superior in drug administration, and may be useful for managing tachyarrhythmia caused by surgery for esophageal cancer.