Antiarrhythmic effect of non-antiarrhythmic drugs: the importance and principles of pharmacological correction of the activity of the renin-angiotensin system in the therapy of cardiac arrhythmias

Objective: to study the effect of losartan on the morpho-functional characteristics of patients with various heart rhythm disorders. 62 patients aged 50 to 70 years (57.4±1.82 years) were included with the following diagnoses: coronary heart disease (stable angina of stress of I–III functional classes) – 80.7% of patients, heart failure I–IIA st. (90.3% of patients), hypertensive disease I–II st. (87.1%), myocardiofibrosis (12.9%). Cardiac arrhythmias were in all patients: ventricular extrasystole – in 36% of the patients examined, supraventricular extrasystole – 29.6%, paroxysmal and persistent forms of atrial fibrillation – 44.8%, permanent form of atrial fibrillation – 27.4%. All patients took basal therapy, to which losartan was added. The studies were carried out twice: when the patient was admitted to the hospital and after 4 weeks of taking losartan. The following methods were used: clinical observation; ECG monitoring with QT interval measurement; Holter monitoring of ECG; Daily monitoring of blood pressure; Echocardiography. A significant decrease in the values of the corrected QT interval and the dispersion of the QT interval, together with the favorable effect of losartan on the heart rate variability, allows one to associate the antiarrhythmic effect of this drug both with its positive effect on the vegetative regulation of the heart tone and with the independent antiarrhythmic activity of the active metabolite losartan EXP3174.