Eibensteiner et al. conducted a retrospective observational study evaluating bolus Landiolol, an ultra-short-acting β1-selective blocker, for rate and rhythm control in prohospital patients with tachydysrhythmias. The study analyzed 111 patients treated by Vienna EMS between August 2023 and June 2024 who received Landiolol boluses for tachysrhythmias. Rate control was defined as a ≥20% reduction from baseline heart rate, while rhythm control was defined as a sustained sinus rhythm on hospital arrival. No adverse effects (cardiac arrest, bradycardia, or allergic reaction) were attributed to Landiolol, and no patients died in the prehospital phase. Hypotension requiring intravenous catecholamines occurred in four patients (3.6%). The median total dose of Landiolol was 20 mg, administered fractionally. Clinical improvement was reported in 58.6% of patients, including rhythm control in 14.4% and rate control in 44.1%. 24 patients received additional antiarrhythmia medication. The authors emphasized that due to Landiolol’s short half-life, repeated dosing may be required to maintain control. They also cautioned the potential risk of thromboembolism following sinus conversion in atrial fibrillation.