Diuretic therapy effects on the signal-averaged ECG parameters of atrial complex and supraventricular arrhythmias in patients with coronary heart disease and chronic heart failure

Aim. To study the signal-averaged ECG (SA-ECG) parameters of atrial complex and supraventricular arrhythmias (SVA) in patients with coronary heart disease (CHD) and chronic heart failure (CHF), treated with diuretics (D) torasemide and furosemide. Material and methods. The study included 107 patients with CHD and CHF. All participants underwent 24-hour ECG monitoring and the registration of SA-ECG atrial complex parameters. In total, 52 patients received furosemide, and 55 were administered torasemide. Results. In both groups, D therapy was associated with some increase in the duration of filtered P and LAS5, as well as a decrease in RMS20. These changes were more pronounced in the furosemide-treated patients. Torasemide demonstrated better effects on the SVA dynamics, which manifested in the decreased numbers of single, paired, and grouped SV extrasystoles. Conclusion. In CHD and CHF patients, the disturbed atrial depolarisation was manifested in negative dynamics of SA-ECG atrial complex parameters. Torasemide therapy did not affect the atrial complex parameters and also reduced SVA incidence, which made torasemide a medication of choice for patients with CHD and CHF.