胸腺腫による心圧排所見を伴う発作性心房細動に対してランジオロールが奏効した1症例

Effectiveness of Landiolol for Paroxysmal Atrial Fibrillation in a Patient with Cardiac Compression due to Recurrent Thymoma

要旨

　胸腺腫術後再発で右肺は含気がなく，急性呼吸不全と混合性アシドーシス，敗血症性ショックのため人工呼吸を開始した。経胸壁心エコーで左房後壁に腫瘤性病変，左房圧排所見を認めた。誘因なく発作性心房細動と低血圧が出現したが，少量のランジオロール投与開始後，速やかに洞調律に復帰し，循環動態も改善した。

　A 58-year-old female patient had a postoperative recurrence of thymoma. Acute respiratory failure and mixed acidosis during opioid rotation were observed, and mechanical ventilation was started. Transthoracic echocardiography for investigation of persistent hypotension showed a mass lesion in the posterior wall of the left atrium and cardiac compression findings. Six hours after the start of mechanical ventilation, paroxysmal atrial fibrillation and hypotension without any trigger occurred. After low dose administration of landiolol was started, the patient quickly returned to sinus rhythm and circulatory dynamics was also improved.