landiolol + levosimendan

Landiolol + levosimendan is a combination therapy involving two distinct agents used in the management of acute decompensated heart failure (dHF), particularly in patients with tachyarrhythmias or low ejection fraction. Landiolol is an ultra-short-acting, highly selective beta-1 adrenergic receptor blocker that provides rapid heart rate control with minimal negative inotropic effects. Levosimendan is a calcium sensitizer and potassium channel opener that enhances myocardial contractility without increasing intracellular calcium levels and also induces vasodilation. The combination aims to simultaneously control tachycardia (via landiolol) and improve cardiac output (via levosimendan), offering hemodynamic stabilization for critically ill patients with severe cardiac dysfunction, including those complicated by sinus or supraventricular tachycardias[1][5]. Clinical case series have shown this combination to be well tolerated, improving cardiac function, normalizing stroke volume, reducing norepinephrine requirements, and facilitating ICU discharge[1][5].