The effect of the glucose-insulin-potassium solution on the p-wave dispersion of the heart failure patients

Heart failure, seems to be an important health problem with a high mortality and morbidity in spite of the new advances of the therapy. Neuroendocrine and circulatory maladaptation processes during the course causes structural, contractile and electrical remodelling. This remodelling produces reentry focuses in the atria which causes atrial fibrillation that wosens the prognosis and the functional capacity of the patient. P-wave dispersion is accepted as an important predictor of the atrial fibrillation. Glucose-insulin-potassium infusion has favorable haemodynamic and metabolic effects. We aimed to investigate the effect of the GIK solution on the P-wave dispersion of the heart failure patients.We included 30 patients with heart failure diagnosis and a low left ventricular ejection fraction (EF<40%) which were hospitalised by our clinic into our study. All patients were randomised to two groups. We administered GIK solution (20 U insülin and 60 mEq KCl in 20% 500 cc dextrose solution) in 8 hours for consecutive 3 days to the Group I and isotonic NaCl solution in the same time in addition to the conventional therapy to the Group II as a control group.We showed that the P-dispersion was significantly lower in the patients in which GIK was administered compared to the control group. When the arrythmia, especially the atrial fibrillation experinced in the coronary care units are considered, decrease of the PD with GIK infusion, so a possible decrease of atrial fibrillation, might be over the alert.Key words: Glucose-insulin-potassium, P wave dispersion, Heart failure