Evidence map›Paper›PMID 40619437›Full record

Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2025

Landiolol bolus application for tachycardic dysrhythmia in the prehospital EMS setting - An observational study of a novel concept.

Felix Eibensteiner, Mario Krammel, Andrea Kornfehl, Roman Brock, Christoph Veigl, Daniel Grassmann, Thomas Hamp, Hans Domanovits, Patrick Sulzgruber, Sebastian Schnaubelt

Abstract readObservational Study
In one paragraph

Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Felix Eibensteiner *Department of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria. felix.eibensteiner@meduniwien.ac.at.
Mario Krammel *Emergency Medical Service Vienna, Vienna, 1030, Austria.
Andrea KornfehlDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Roman BrockDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Christoph VeiglDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Daniel GrassmannEmergency Medical Service Vienna, Vienna, 1030, Austria.
Thomas HampEmergency Medical Service Vienna, Vienna, 1030, Austria.
Hans DomanovitsDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Patrick SulzgruberDivision of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, 1090, Austria.
Sebastian SchnaubeltDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, 1090, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTachydysrhythmias are a challenging aspect of emergency medicine, with atrial fibrillation being the most common. Electrical cardioversion is recommended for hemodynamically unstable patients, while treatment varies according to the dysrhythmia subtype in others. Landiolol, a relatively new ultra-short-acting cardioselective beta-blocker, may be a promising option for prehospital use due to its advantageous pharmacological properties.

methodsThis observational study included all cases of Landiolol bolus administration of the Emergency Medical Service (EMS) Vienna from 08/2023 until 06/2024. Data were extracted from EMS reports and hospital records. The primary endpoint was drug safety and adverse events. Secondary outcomes were the effect on hemodynamic and rate- and rhythm control.

resultsWe analysed reports of 111 patients having received push-dose Landiolol (median 74 [interquartile ranges (IQR) 62-81] years; 57% female; dosage median 20 [IQR 7-20] mg). Leading symptoms were palpitations (35%), dyspnoea (26%), and chest pain (18%), with atrial fibrillation as the most common dysrhythmia (64%). No allergic reactions, relevant bradycardias or cardiac arrests were detected immediately after Landiolol administration. In 59%, an improvement in patients' condition was reported. Rhythm control was achieved in 14%, and rate control in 44%. No effect was seen in 34%. The heart rate was significantly (median 170 [IQR 150-190] vs. median 123 [IQR 99 - 140] bpm; p < 0.001) lower after drug administration. Phenylephrine administration with a probable causal relation to Landiolol was needed in four cases (3.6%). Overall, there was no relevant effect on mean arterial blood pressure (median 90 [IQR 80-105] vs. median 91 [IQR 77-101] mmHg; p = 0.362).

conclusionPush-dose Landiolol could be a conceivable future therapeutic option for tachydysrhythmia in the EMS setting. In particular, a high incidence of rate or rhythm control can be achieved. Utilization should be allocated to non-compensatory tachycardia only. Drug response and control groups with other drugs should be further investigated.

Indexed as

Adrenergic beta-AntagonistsAnti-Arrhythmia AgentsAtrial FibrillationEmergency Medical ServicesMorpholinesTachycardiaUreaAgedAged, 80 and overAustriaFemaleHumansMaleMiddle AgedAdrenergic beta-AntagonistsAnti-Arrhythmia AgentslandiololMorpholinesUreaBetablockerDysrhythmiaEmergencyEMSLandiololPrehospital

Identifiers

PMID40619437
PMCPMC12232707

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.