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Landiolol and septic ventricular arrhythmias: Revisiting the inflammation-fibrosis-Nav1.5/Cx43 electro-structural axis
Jiao Tang, Xue Deng, Zi-Ran Jia, Tao Wang, Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, Chengdu 610041, Sichuan Province, China
Jiao Tang, Department of Pediatrics, West China Longquan Hospital Sichuan University/The First People’s Hospital of Longquanyi District, Chengdu 610100, Sichuan Province, China
Ting Luo, Zhuoma Gesang, Quzhun Danzeng, Tao Wang, Department of Pediatrics, Xizang Autonomous Region Women’s and Children’s Hospital (Xizang Autonomous Region Maternal and Child Health Care Hospital), Lhasa 850000, Xizang Autonomous Region, China
Co-first authors: Jiao Tang and Xue Deng.
Author contributions: Tang J and Deng X analyzed the target article and drafted the manuscript, have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Luo T and Gesang Z contributed to intellectual content development and critical revision; Jia ZR and Danzeng Q contributed to study conception, study design, and manuscript preparation; Wang T served as guarantor for the integrity of the work, supervised the literature review, and critically edited the manuscript; and all authors read and approved the final version.
Supported by Xizang Autonomous Region Science and Technology Program, No. XZ202501YD0006; and Medical Science Research Project of Sichuan Province, No. S23014.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Corresponding author: Tao Wang, MD, Chief Physician, Department of Pediatrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education; Key Laboratory of Development and Diseases of Women and Children of Sichuan Province, No. 20 South Renmin Road, Chengdu 610041, Sichuan Province, China. 44871875@qq.com
Received: February 27, 2026
Revised: March 22, 2026
Accepted: April 21, 2026
Published online: September 26, 2026
Processing time: 204 Days and 13.6 Hours
Revised: March 22, 2026
Accepted: April 21, 2026
Published online: September 26, 2026
Processing time: 204 Days and 13.6 Hours
Core Tip
Core Tip: Hu et al demonstrated that landiolol reduced ventricular arrhythmia burden in a septic rat model while attenuating inflammation, apoptosis, and fibrosis, improving conduction heterogeneity, and being accompanied by reciprocal changes in Cx43 and Nav1.5 expression. The key message is conceptual rather than definitive: Ultra-short-acting beta1 blockade may benefit selected septic patients by modulating an inflammation-fibrosis-Nav1.5/Cx43 electro-structural axis, not merely by slowing heart rate. Future studies should explicitly link expression to function through INa and gap-junction or hemichannel assays, define the safe dose and time window, and translate this framework through phenotype-guided clinical implementation.