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Effects of MgSO4 and glucose, insulin and potassium (GIK) on atrial conduction during the first 12 hours after DC-conversion of chronic atrial fibrillation

Ingemansson, Max LU ; Carlson, Jonas LU ; Platonov, Pyotr LU and Olsson, Stig B (2001) In Scandinavian Cardiovascular Journal1997-01-01+01:00 35(5). p.340-346
Abstract
OBJECTIVE: To investigate changes in atrial conduction induced by MgSO4 and glucose, insulin and potassium (GIK) during the first 12-h period of sinus rhythm after successful DC-conversion of chronic atrial fibrillation (CAF). METHODS: Signal-averaged P-wave duration, QRS-duration and PQ-time were recorded in 20 patients who were randomly assigned to control or intervention. Ten patients received no infusates (control group) and 10 patients received MgSO4 and GIK infusions (intervention group). P-wave duration was determined from the X-, Y- and Z-leads, which were further combined to obtain a spatial magnitude. P-wave morphology was studied by analysing global activation patterns and discrete components from the calculated spatial... (More)
OBJECTIVE: To investigate changes in atrial conduction induced by MgSO4 and glucose, insulin and potassium (GIK) during the first 12-h period of sinus rhythm after successful DC-conversion of chronic atrial fibrillation (CAF). METHODS: Signal-averaged P-wave duration, QRS-duration and PQ-time were recorded in 20 patients who were randomly assigned to control or intervention. Ten patients received no infusates (control group) and 10 patients received MgSO4 and GIK infusions (intervention group). P-wave duration was determined from the X-, Y- and Z-leads, which were further combined to obtain a spatial magnitude. P-wave morphology was studied by analysing global activation patterns and discrete components from the calculated spatial magnitude signal. RESULTS: No changes in the measured parameters were seen in the control group. The P-wave duration, QRS-duration and PQ-time increased from 139(13) [mean(SD)] to 149(15) (p < 0.01), 90(7) to 94(9) (p < 0.05) and 188(10) to 207(13) ms (p < 0.01). respectively, after bolus infusion of MgSO4. The time from the start of the P-wave to its 1st and 2nd max. locations increased by 6 ms (p < 0.01) in both cases after bolus infusion of MgSO4 and had reversed after 10 h of MgSO4 and GIK infusion. P-wave duration and PQ-time decreased after 10 h of MgSO4 and GIK infusion, from 149(34) (bolus) to 138(12) and from 207(13) to 195(27) ms (p < 0.05), respectively, in spite of an even higher serum Mg concentration at the end of this period. CONCLUSION: Bolus infusion of MgSO4 2 h after DC-conversion of CAF produced an intra-atrial conduction delay that could be reversed by adding a GIK infusion, in spite of a concomitant increase in serum Mg concentration. No recovery of the intra-atrial conduction delay, seen after DC-conversion of CAF, was observed in either of the two groups during the 12-h study period. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial, Conduction, Fibrillation, Glucose, Insulin, Magnesium, Potassium
in
Scandinavian Cardiovascular Journal1997-01-01+01:00
volume
35
issue
5
pages
340 - 346
publisher
Taylor & Francis
external identifiers
  • pmid:11771826
  • scopus:0035543028
ISSN
1651-2006
DOI
10.1080/140174301317116325
language
English
LU publication?
yes
id
535eb07f-bb3c-4722-b019-56d1583fb21d (old id 1123095)
date added to LUP
2008-06-30 16:00:21
date last changed
2018-05-29 10:49:21
@article{535eb07f-bb3c-4722-b019-56d1583fb21d,
  abstract     = {OBJECTIVE: To investigate changes in atrial conduction induced by MgSO4 and glucose, insulin and potassium (GIK) during the first 12-h period of sinus rhythm after successful DC-conversion of chronic atrial fibrillation (CAF). METHODS: Signal-averaged P-wave duration, QRS-duration and PQ-time were recorded in 20 patients who were randomly assigned to control or intervention. Ten patients received no infusates (control group) and 10 patients received MgSO4 and GIK infusions (intervention group). P-wave duration was determined from the X-, Y- and Z-leads, which were further combined to obtain a spatial magnitude. P-wave morphology was studied by analysing global activation patterns and discrete components from the calculated spatial magnitude signal. RESULTS: No changes in the measured parameters were seen in the control group. The P-wave duration, QRS-duration and PQ-time increased from 139(13) [mean(SD)] to 149(15) (p &lt; 0.01), 90(7) to 94(9) (p &lt; 0.05) and 188(10) to 207(13) ms (p &lt; 0.01). respectively, after bolus infusion of MgSO4. The time from the start of the P-wave to its 1st and 2nd max. locations increased by 6 ms (p &lt; 0.01) in both cases after bolus infusion of MgSO4 and had reversed after 10 h of MgSO4 and GIK infusion. P-wave duration and PQ-time decreased after 10 h of MgSO4 and GIK infusion, from 149(34) (bolus) to 138(12) and from 207(13) to 195(27) ms (p &lt; 0.05), respectively, in spite of an even higher serum Mg concentration at the end of this period. CONCLUSION: Bolus infusion of MgSO4 2 h after DC-conversion of CAF produced an intra-atrial conduction delay that could be reversed by adding a GIK infusion, in spite of a concomitant increase in serum Mg concentration. No recovery of the intra-atrial conduction delay, seen after DC-conversion of CAF, was observed in either of the two groups during the 12-h study period.},
  author       = {Ingemansson, Max and Carlson, Jonas and Platonov, Pyotr and Olsson, Stig B},
  issn         = {1651-2006},
  keyword      = {Atrial,Conduction,Fibrillation,Glucose,Insulin,Magnesium,Potassium},
  language     = {eng},
  number       = {5},
  pages        = {340--346},
  publisher    = {Taylor & Francis},
  series       = {Scandinavian Cardiovascular Journal1997-01-01+01:00},
  title        = {Effects of MgSO4 and glucose, insulin and potassium (GIK) on atrial conduction during the first 12 hours after DC-conversion of chronic atrial fibrillation},
  url          = {http://dx.doi.org/10.1080/140174301317116325},
  volume       = {35},
  year         = {2001},
}