Abstract

Objectives: This study aimed to investigate the risk factors associated with developing cardiac arrhythmias in patients with acute heart failure treated with levosimendan.
Materials and methods: A retrospective analysis was conducted in patients diagnosed with acute heart failure or acute exacerbation of chronic heart failure treated with levosimendan. The patients were divided into arrhythmia and non-arrhythmia groups based on the presence of rapid-type arrhythmias. Logistic regression analysis was used to identify independent risk factors for levosimendan-induced arrhythmias.
Results: Among the 250 patients, 49 (19.60%) experienced nine types of cardiac arrhythmias, the most common being atrial fibrillation (28.57%). The highest incidence of arrhythmias occurred within 48 hours of levosimendan infusion (77.6%). Multivariate analysis indicated that the lowest serum potassium concentration within 5 days after drug administration (odds ratio (OR) 0.410, p = 0.010, 95% confidence interval (CI) 0.209 – 0.805), micro-pump speed of > 0.2 μg/kg/min (OR 3.106, p = 0.039, 95% CI 1.584 – 11.789), and concomitant use of drugs that prolong the QT interval (OR 4.226, p = 0.001, 95% CI 1.850 – 9.657) were independent risk factors for levosimendan-induced arrhythmias. The incidence of arrhythmias increased when the lowest serum potassium concentration within 5 days after drug administration was below 3.94 mmol/L.
Conclusion: This study identified risk factors associated with levosimendan-induced arrhythmias. Clinicians should monitor at-risk patients when administering levosimendan. When using levosimendan in clinical practice, it is necessary to maintain a serum potassium concentration above 3.94 mmol/L.

*These authors contributed equally to this work.

Author Details

Authors

• Wenguang Liu¹*
• Xiaowu Wang²*
• Dong Wu³
• Zhen Ma¹
• Bin Ning¹

Departments

• ¹ Department of Cardiovascular Medicine, Fuyang People’s Hospital,
• ² Department of Clinical Laboratory, The Second People’s Hospital of Fuyang City, Fuyang Infection Disease Clinical College of Anhui Medical University, and
• ³ Department of Pharmacy, Fuyang People’s Hospital, Fuyang, Anhui, China

Address

Prof. Bin Ning
Department of Cardiovascular Medicine
Fuyang People’s Hospital
Fuyang 236000, Anhui, China
Email: [email protected]

Citation