The protective effect of glucose insulin potassium on the response to atrial pacing

Abstract

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.