Özet:

Atrial fibrillation (AF) is a common arrhythmia in patients with chronic heart failure (HF), and it is associated with worse prognosis. Although there are some evidence that mineralocorticoid receptor antagonists may reduce the risk of developing AF in such patients, the evidence in this regard is insufficient. Measurement of atrial conduction time on electrocardiography (ECG) is a commonly used method to evaluate the risk of developing AF. This study aims to evaluate the effect of spironolactone on atrial conduction in ECG in patients with HF with reduced ejection fraction (EF). Twenty-three patients with compensated HF with reduced EF and sinus rhythm were included and they were monitored for six months (spironolactone group: 12 patients, control group: 11 patients). The basic clinical and laboratory characteristics of the patients were detected. At baseline and at the end of six-month follow-up, ECG and echocardiographic characteristics were compared within and between the groups. After six-month follow-up in the spironolactone group, P maximum and P dispersion values decreased significantly compared to baseline (p=0.001 and <0.001, respectively). In the control group, these measurements were similar at baseline and at the end of the six-month follow-up period. According to the two-way repeated measurement results, P max and P dispersion values decreased significantly compared to the control group at the end of the six-month follow-up period in the spironolactone group (p=0.011 and 0.002, respectively). In patients with compensated HF with reduced EF and sinus rhythm, spironolactone provides significant improvements in atrial conduction time, which presents an increased risk for AF.

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