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

Atrial fibrillation (AF) has adverse effects on the disease prognosis and the functional capacity during heart failure. P wave dispersion has been considered as one of the most important parameters predicting the development of AF. It is known that glucose-insulin-potassium (GIK) infusion has favorable metabolic and hemodynamic effects. The aim of our study is to investigate the effects of GIK infusion on P wave dispersion in patients with heart failure. In our study, 30 patients with the diagnosis of heart failure and a low left ventricular ejection fraction (EF<40%) were included. Fifteen patients randomized to GIK solution (20 U insulin and 60 mEq KCl in 20% 500 ml dextrose solution) in 8 hours for consecutive 3 days (Group I) and other 15 patients were randomized to isotonic NaCl solution in addition to the conventional therapy (Group II, control). Twelve-lead electrocardiography were recorded in all patients to detect the P wave dispersion. P wave dispersion was calculated between the Group I and Group II patients before the study respectively (19.4 +/- 7.5 and 19 +/- 6.3) (p>0.05). In Group I, P wave dispersion measured after GIK infusion was 13 +/- 6.5. In group II, P wave dispersion measured after 0.9% NaCl solution infusion were 20.4 +/- 6.4. P wave dispersion was found significantly lower in patients administrated GIK infusion (p=0.001). According to the present study, we showed that the P wave dispersion which predicts AF was significantly lower in the patients treated with GIK than in the control group.