The protective effect of glucose-insulin-potassium on the response to atrial pacing.
The effects of glucose-insulin-potassium infusion (GIK) on atrial pacing-induced angina, ST depression, abnormal left ventricular end-diastolic pressure during pacing interruption (LVEDPi) and lactate metabolism (L), were studied in 18 patients: ten had angina during pacing = Ischemic group, and eight (5 normals and 3 with coronary artery disease) remained asymptomatic = Nonischemic group. The study consisted of 8-10 minute periods of control, pacing and recovery, before and after GIK. No untoward effects were observed. Comparison of the pacing responses (GIK vs pre-GIK states) showed that during GIK, angina occurred in only 4 patients, while significantly less severe changes were observed in ST depression (1.4 +/-0.5 vs 2.4 +/- 0.4 mm) and LVEDPi (16 +/- 3 vs 23 +/- 3 mm Hg). Lactate extraction was also higher (8.1 +/- 10.9 vs -5.2 +/- 11.1%), but not significantly so, although L became normal in 4 subjects and improved in another. These results indicate that GIK infusion was well tolerated and had a beneficial effect on pacing-induced myocardial ischemia.
D000328:Adult; D000787:Angina Pectoris / Q000188:drug therapy; D001786:Blood Glucose; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy* / Q000628:therapy; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005947:Glucose / Q000627:therapeutic use*; D006339:Heart Rate; D006439:Hemodynamics; D006801:Humans; D007328:Insulin / Q000627:therapeutic use*; D007773:Lactates / Q000097:blood; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D011188:Potassium / Q000097:blood / Q000627:therapeutic use*
D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D007773:Lactates; D005947:Glucose; D011188:Potassium