[Effect of hemodynamic changes on cardiac rhythm disorders: experience with long-term intravenous administration of nitroglycerin in patients with chronic heart failure].

Abstract

In 15 patients with chronic congestive heart failure (CHF), heart rhythm was analysed in normal haemodynamics achieved by 24-hour nitroglycerin (NG) infusion. The NG dose was titrated until the pulmonary wedge pressure (PWP) was reduced up to less than 15 mm Hg; during further 24 hours the infusion rate was unchanged (mean 144 +/- 16 mgk/min). The control group included 12 patients with CHF to whom no NG infusions were performed. There was no significant difference between the groups in mean daily number of ventricular extrasystoles (VE), coupled VE, runs of ventricular tachycardia and maximal gradation of ventricular rhythm disturbances (VRD). VRD in the first 12 hours, i. e. during greatest haemodynamics alterations, and in the next 12 hours of the infusion were compared separately as well as VRD in every 3 hours of the infusion. The groups did not differ significantly in number and degree of VRD. It is thus supposed that VRD in patients with severe CHF are independent of haemodynamic factors.