Comparative effects of levosimendan and dobutamine infusion on p wave dispersion in patients with acute decompensated heart failure

We aimed to evaluate the comparative effects of levosimendan and dobutamine on P-wave dispersion (PWD) in the patients with acute decompensated heart failure (ADHF). Materials and methods: The study population consisted of 40 patients (mean age = 68 years, 23 men, NYHA class III-IV) presented with ADHF. Patients were randomized to intravenous levosimendan (n = 20) or dobutamine (n = 20) groups. The P-wave duration measurements were calculated in 12-lead surface ECG simultaneously and recorded before and after treatment. Manual measurements of P-wave duration were performed with digital calipers on a high resolution computer screen by two cardiologists not aware of the patients' clinical data. Results: There were no significant changes in P max in the dobutamine group whereas a significant decrease was observed in the levosimendan group after the infusion. The levosimendan infusion significantly reduced PWD (from 40 msec to 30 msec, P < 0.001) but the dobutamine infusion has no effect on PWD. In hospital new onset atrial fibrillation (AF) frequency was similar among two groups. Conclusion: Levosimendan infusion significantly reduces PWD compared to dobutamine infusion in our study population. This finding may be related to hemodynamic improvements provided by levosimendan.