esmolol / Generic mfg. - LARVOL DELTA

What If We Let It Fibrillate? New Perspective on Atrial Fibrillation in Sepsis. (PubMed, Curr Med Sci) - "Studies with ultrashort-acting beta-blockers, such as esmolol and landiolol, have shown that hemodynamic stabilization may occur even in the absence of sinus rhythm restoration. Recognizing AF as a potential adaptive rhythm reframes research priorities: identifying biomarkers of atrial inflammation, stratifying patients according to hemodynamic impact, and testing permissive versus corrective strategies in prospective trials. The permissive AF strategy proposed herein is expected to foster patient-centered care and reduce iatrogenic harm in the complex interplay between sepsis and the heart."

Journal • Atrial Fibrillation • Cardiovascular • Critical care • Infectious Disease • Inflammation • Septic Shock

Permanent Junctional Reciprocating Tachycardia (PJRT): A Rare Case of Refractory Neonatal SVT (SCCM 2026) - "There, he underwent six attempts of transcutaneous pacing and was started on a combination of esmolol, flecainide, and amiodarone. However, in neonates this procedure is very rarely performed. Given its resistance to pharmacologic agents, PJRT demands early recognition and a targeted approach to management in pediatric and neonatal populations."

Clinical • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Ventricular Tachycardia

Utilization of Intravenous Immunoglobulin for Basedow Paraplegia in Thyroid Storm (SCCM 2026) - "After 12 days of management with cholestyramine, dexamethasone, esmolol, and methimazole, thyroid hormone levels normalized, and sedation was stopped. Given the theorized immune-mediated aspect of BP, IVIG, a therapy utilized for immune-mediated myopathies, was trialed. In this case of thyrotoxic myopathy, normalization of thyroid hormone levels failed to resolve the paralysis, and muscle strength improved after a 5-day course of IVIG."

Atrial Fibrillation • Cardiovascular • CNS Disorders • Myasthenia Gravis • Myositis

Severe Pediatric Caffeine Toxicity: Early Extracorporeal Therapy With TPE and CRRT (SCCM 2026) - "She was intubated and treated with anticonvulsants, epinephrine infusion, and propofol for transport. In the PICU, a 240 bpm wide-complex tachycardia was treated with a 100 mg lidocaine load, three synchronized cardioversions, and titration of an esmolol infusion for rate control.The initial caffeine level was 241 mcg/mL (therapeutic range 5-20 mcg/mL)...Its low molecular weight, minimal protein binding, and small volume of distribution favor clearance with dialysis. This case highlights that combined TPE and CRRT may rapidly reduce toxic levels and manage rhabdomyolysis, supporting early extracorporeal therapy in severe pediatric caffeine poisoning."

Clinical • Alzheimer's Disease • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Depression • Epilepsy • Hypotension • Major Depressive Disorder • Migraine • Mood Disorders • Nephrology • Pediatrics • Polycystic Ovary Syndrome • Renal Disease

Characterization of Esmolol Use for Acute Aortic Syndrome at a Tertiary Academic Medical Center (SCCM 2026) - "Esmolol was not effective in achieving an initial heart rate goal in 64% of patients. Despite the relaxation of heart rate goals in 67% of the study population, 37% still never reached their target heart rate. Patients not meeting their initial heart rate goal required higher esmolol doses and received larger volumes from the infusion."

Cardiovascular

Esmolol Versus Labetalol in Acute Aortic Syndromes (SCCM 2026) - "In this retrospective crossover analysis of AAS, there was a higher proportion of esmolol infusions that failed to achieve hemodynamic goals compared to labetalol, but no statistically significant differences were observed. Labetalol was associated with a lower rate of secondary vasoactive agent use, fewer therapy changes, and reduced drug volume requirements compared to esmolol."

Cardiovascular

Rethinking Our PLEXit Strategy in Thyroid Storm: When to Cut Our Losses on Medical Therapy Alone (SCCM 2026) - "Medical therapy includes methimazole or propylthiouracil, beta blocker, iodine, glucocorticoids, and cholestyramine...Despite treatment for thyroid storm with methimazole, esmolol, potassium iodide, hydrocortisone, and cholestyramine, she continued to deteriorate with worsening shock requiring multiple vasopressors, liver and kidney failure, and was subsequently intubated...We argue that PLEX should be considered earlier in medically refractory cases, such as in our patient, whose acute liver failure likely disrupted thyroid metabolism. Prompt initiation of PLEX could be a life-saving measure, and this case illustrates the importance of considering this intervention earlier in medically refractory thyroid storm."

Atrial Fibrillation • Cardiovascular • Congestive Heart Failure • Heart Failure • Hepatology • Liver Failure • Metabolic Disorders • Nephrology • Pulmonary Disease • Renal Disease • Respiratory Diseases

A Rare Case of Strong Acid Poisoning Presenting With Refractory Electrical Storm (SCCM 2026) - "Despite antiarrhythmic drugs (amiodarone, lidocaine, esmolol), electrolyte correction, and defibrillation, VF persisted. This case emphasizes the importance of early recognition, multidisciplinary care, and the potential role of ECMO in managing toxic cardiac complications when conventional therapies fail.Artificial intelligence assistance (ChatGPT, OpenAI) was used in the drafting and English-language editing of this case report. All clinical content and interpretations were verified by the authors."

Clinical • Cardiovascular • Cognitive Disorders • Endocrine Disorders • Gastrointestinal Disorder • Metabolic Disorders

Dual Threat: Hemodynamic Challenges in Stroke With Acute Type A Aortic Dissection (SCCM 2026) - "Esmolol and nicardipine infusions were started with goals of systolic BP < 120 mmHg and HR < 60 bpm...Postoperatively, BP was maintained around 140 mmHg with HR < 100 bpm using norepinephrine, nitroglycerin, and nicardipine infusions...Prioritizing aortic protection may risk cerebral hypoperfusion, while maintaining cerebral perfusion may exacerbate aortic wall injury. This case emphasizes the importance of tailored decision-making to navigate conflicting therapeutic goals and reduce morbidity in critically ill patients."

Cardiovascular • CNS Disorders • Hypertension • Ischemic stroke

FLAIL MITRAL VALVE LEAFLET LEADING TO DYNAMIC LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION IN HYPERTROPHIC CARDIOMYOPATHY (ACC 2026) - "Dobutamine was stopped, and esmolol started. Acute severe MR causes profound vasodilation and catecholamine surge which can unmask an otherwise asymptomatic HCM and was a major driver to this patient's acute hemodynamic compromise."

Cardiomyopathy • Cardiovascular • Hypertension • Hypertrophic Cardiomyopathy • Pulmonary Disease • Respiratory Diseases

RAGING HEART, CALM THYROID: REFRACTORY AF CONTROLLED WITH IV AMIODARONE WITHOUT WORSENING HYPERTHYROIDISM (ACC 2026) - "Electrocardiogram showed sinus tachycardia.Shortly after admission, the patient developed atrial fibrillation (AF) with rapid ventricular response (RVR) which was refractory to multiple doses of IV metoprolol, IV diltiazem, and two rounds of synchronized cardioversion. He was subsequently started on IV esmolol drip and digoxin.Further workup revealed suppressed TSH (<0.01 mIU/L) with elevated free T4 (2.82 ng/dL) and T3 (53.17 ng/dL)...He also received hydrocortisone, methimazole, IV fluids, and antibiotics, leading to hemodynamic stabilization... IV amiodarone can be considered in thyroid storm with refractory tachyarrhythmias. Potential mechanisms may include induction of the Wolff-Chaikoff effect and inhibition of peripheral T4 to T3 conversion. Short term IV use has been reported to stabilize both arrhythmias and thyroid function, although robust clinical data are lacking."

Atrial Fibrillation • Cardiovascular • Endocrine Disorders • Infectious Disease • Nephrology • Septic Shock

WHEN INFECTION MEETS INTIMA: TYPE B AORTIC DISSECTION WITH SYPHILITIC AORTITIS (ACC 2026) - "Later, blood pressure was controlled with esmolol, and oral antihypertensives were adjusted... AD can arise from various causes, and thorough evaluation is critical when both common and rare factors like hypertension and syphilis are present. Lifelong surveillance is necessary due to the potential for disease progression."

Cardiovascular • Diabetes • Dyslipidemia • Heart Failure • Hypertension • Infectious Disease • Inflammation • Metabolic Disorders • Pulmonary Embolism • Respiratory Diseases • Type 2 Diabetes Mellitus

WHEN THE THYROID STORMS THE HEART: A CHALLENGING CASE OF THYROTOXICOSIS-INDUCED CARDIOGENIC SHOCK REQUIRING VA-ECMO (ACC 2026) - "Of note, patient had not taken her methimazole and atenolol for several months...Patient was initiated on high dose steroids, esmolol, methimazole, potassium iodide, and lithium... Thyrotoxicosis-induced circulatory collapse portends a grim prognosis. It is critical to quickly diagnose and treat this condition, harnessing the power of a multidisciplinary team. Prompt initiation of VA-ECMO often becomes necessary to offer a positive outcome, although sadly in our patient's case, it was still not enough."

Clinical • Acute Kidney Injury • Cardiovascular • Endocrine Disorders • Grave’s Disease • Heart Failure • Hematological Disorders • Hepatology • Liver Failure • Nephrology • Renal Disease • Respiratory Diseases • Thrombocytopenia

CARDIOPULMONARY RESUSCITATION INDUCED AORTIC DISSECTION (ACC 2026) - "These findings led to the discontinuation of IV anticoagulation and initiation of IV esmolol... Poor quality CPR can result in aortic dissection in addition to other organ injuries. It is essential to monitor the quality of the CPR and to keep a high index of suspicion for organ/vascular injury after CPR to allow for prompt management."

Atrial Fibrillation • Cardiovascular • CNS Disorders • Depression • Hypertension • Musculoskeletal Diseases • Orthopedics

Severe Hypoglycemia-Induced Seizure in a Four-Year-Old Following Initiation of Nadolol for Supraventricular Tachycardia. (PubMed, Cureus) - "History included refractory supraventricular tachycardia previously managed with esmolol and propranolol. Endocrinology recommended a formal fasting study prior to discharge. Clinicians should monitor glucose closely and educate caregivers on early recognition of hypoglycemia when initiating non-selective beta-blockers in young children."

Journal • Cardiovascular • CNS Disorders • Endocrine Disorders • Epilepsy • Hypoglycemia • Pediatrics • Severe Hypoglycemia • Ventricular Tachycardia

Systolic-Synchronized Intraventricular Pump with an Embedded Bio-Impedance Sensor Adjusting Pump Parameters to LV Unloading and Impairment Levels (ISHLT 2026) - "To facilitate this personalized approach, a bio-impedance sensor was embedded into the FM allowing for the continuous monitoring of hemodynamic and anatomical parameters.Methods Acute implantation of a FM was conducted in a healthy calf with esmolol-induced contractility and altered cardiac output to assess the hemodynamic performance of the pump...In a HF patient, the additional SV value should be higher, as the heart's baseline ejection velocity is lower 0.6-0.8 m/s, whereas in a healthy calf, the ejection velocity was near the pump outlet velocity 1 m/s. The current work will provide valuable information to clinicians to optimize the FM therapy and achieve myocardial recovery."

Cardiovascular

Anaesthetic management of neurogenic atrial fibrillation with rapid ventricular response in a patient undergoing decompressive hemicraniectomy. (PubMed, BMJ Case Rep) - "He underwent emergency decompressive hemicraniectomy under general anaesthesia with remifentanil, dexmedetomidine, midazolam, etomidate, esmolol and low-dose sevoflurane plus transtracheal and topical airway blocks. This case emphasises the importance of the application of neuroprotective and cardioprotective strategies, including sympatholysis and vigilant monitoring. The neurogenic-cardiac dysfunction may be reversible with timely neurosurgical cranial decompression and medical management."

Journal • Anesthesia • Atrial Fibrillation • Cardiovascular • CNS Disorders • Congestive Heart Failure • Heart Failure • Ischemic stroke

Vasoactive drugs and the distribution of crystalloid fluid during acute sepsis. (PubMed, J Intensive Med) - "A bolus infusion of 20-25 mL/kg of crystalloid fluid was given 1 h later, together with therapeutic doses of phenylephrine, norepinephrine, isoprenaline, dopamine, or esmolol...Vasoactive drugs were less effective in septic compared to non-septic sheep. Most importantly, acute sepsis was characterized by a marked accumulation of fluid in an interstitial fluid space with slow turnover."

Journal • Infectious Disease • Inflammation • Septic Shock

Inhibitory effects and molecular interaction analysis of emergency cardiac drugs on human serum paraoxonase 1: an integrated in vitro and in silico approach. (PubMed, Arch Physiol Biochem) - "Molecular docking revealed strong binding affinity of esmolol to the PON1 active site, which was further supported by molecular dynamics simulations over 150 ns. Discussion and The findings indicate a potential interaction between commonly used emergency cardiac drugs and PON1, highlighting the importance of evaluating off-target effects on critical metabolic enzymes in cardiovascular therapy."

Journal • Preclinical • Cardiovascular • PON1

Mutation of a Cysteine Residue in LAMP2 Affecting a Disulfide Bridge in a Patient with Danon Disease (ACMG 2026) - "Treatment and Management The patient was started on esmolol, then achieved arrhythmia control after transition to metoprolol...Conclusion Cysteine residues involved in disulfide bridges are important for the stabilization of the prism motif and function of LAMP2 protein. Further study of patients with Danon Disease and cardiomyopathy in general may reveal more individuals with missense variants in these important residues, and other variants that could help explain mechamisms for loss of protein function."

Clinical • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Hepatology • Hypertrophic Cardiomyopathy • Ophthalmology • Ventricular Tachycardia • LAMP1 • LAMP2

Positional and ventilatory mechanics in the unexpected resolution of glycopyrrolate-induced tachycardia: a case report. (PubMed, Ewha Med J) - "The tachycardia was unresponsive to esmolol, labetalol, and fentanyl but resolved unexpectedly after the tidal volume was reduced from 8 to 6 mL/kg. Drug-induced tachycardia or arrhythmia occurring in the LLD position under mechanical ventilation may be attenuated by adopting a low tidal volume ventilation strategy (6 mL/kg)."

Journal • Anesthesia • Cardiovascular

THE SECOND ACT: RECURRENCE OF ATRIAL TACHYCARDIA AFTER SUCCESSFUL ATRIAL FLUTTER CARDIOVERSION (WRMC 2026) - "This persisted despite treatment with sequential maternal antiarrhythmic therapy (sotalol, digoxin, flecainide)...AET was successfully treated with esmolol and then sotalol. Heart failure was treated with milrinone and cardiac function gradually recovered over the next 6 days (LVEF 60%)...This challenges our understanding of atrial flutter as a standalone arrhythmia and emphasizes the need for extended cardiac monitoring beyond the conventional post-cardioversion observation period in high-risk infants. Newborn's ECG Showing Atrial Ectopic Tachycardia at 48 Hours of Life"

Cardiovascular • Congestive Heart Failure • Heart Failure

Comparison of Efficacy and Safety Between Landiolol and Esmolol in Critically Ill Patients with Tachycardia (ChiCTR) - P=N/A | N=120 | Not yet recruiting | Sponsor: The First Affiliated Hospital with Nanjing Medical University; The First Affiliated Hospital with Nanjing Medical University

New trial • Cardiovascular

Effects of low-dose dexmedetomidine combined with esketamine infusion on sleep in non-mechanical ventilation patients with sepsis in ICU: a multicenter, randomized, double-blind, placebo-controlled study (ChiCTR) - P1 | N=376 | Recruiting | Sponsor: Peking University First Hospital; Peking University First Hospital

New P1 trial • Infectious Disease • Septic Shock

The impact of intraoperative esmolol on postoperative cardiovascular adverse events in patients with coronary artery disease undergoing non-cardiac surgery: A single-center, bidirectional cohort study (ChiCTR) - P=N/A | N=1096 | Recruiting | Sponsor: Shandong Provincal Hospital; Shandong Provincial Hospital Affiliated to Shandong First Medical University

New trial • Cardiovascular • Coronary Artery Disease