Landiolol for Rate Control in Decompensated Heart Failure Due to Atrial Fibrillation
Status:
Recruiting
Trial end date:
2023-12-31
Target enrollment:
Participant gender:
Summary
The study will include patients with acute heart failure with reduced left ventricular
ejection fraction (<40%) triggered by atrial fibrillation (AF) with a heart rate of >130/min.
Patients in cardiogenic shock, critical state, or patients requiring emergent electric
cardioversion during the first 2 hours will be excluded. The patients will be randomized
(1:1) to a strategy of initial intensive heart rate control using continuous infusion of
landiolol and boluses of digoxin vs. standard approach to the rate control without the use of
landiolol. All patients will receive recommended pharmacotherapy of acute heart failure
(diuretics, nitrates, inotropes in patients with signs of low cardiac output - preferentially
milrinone or levosimendan). The patients will undergo hemodynamic monitoring, laboratory
testing, evaluation of symptoms, and quantification of lung water content by ultrasound for
48 hours. The study will test a hypothesis whether patients treated with initial intensive
heart rate control with the preferential use of landiolol will achieve faster heart rate
control, compensation of heart failure, and relief of heart failure symptoms without causing
hypotension or deterioration of heart failure.