OBJECTIVE: To probe into the effects of amiodarone combined with sacubitril valsartan in the treatment of dilated cardiomyopathy（DCM） complicated with cardiac arrhythmia（CA） on the improvement of electrocardiograph rhythm. METHODS: Totally 125 patients with DCM complicated with CA admitted into Department of Cardiovascular Medicine

the Eighth Affiliated Hospital of Xinjiang Medical University from Feb. 2018 to Oct. 2020 were selected and randomly divided into observation group（63 cases） and control group（62 cases）. Both groups were given conventional therapy

on that basis

the control group was treated with amiodarone and benazepril

the observation group was given amiodarone combined with salcubatrium valsartan. The clinical efficacy

adverse drug reactions

cardiac function

ECG rhythm and transforming growth factor-β1（TGF-β1）/cell transduction molecule（Smad2） signaling pathways of the two groups were observed

and the relationship between TGF-β1/Smads signaling pathway indicators and clinical efficacy was analyzed. RESULTS: The total effective rate of observation group was 92.06%（58/63）

which was higher than 74.19%（46/62） of the control group

with statistically significant difference（P<0.05）. At 1 month and 3 months of treatment

the left ventricular ejection fraction was higher in both groups than before treatment

and that of the observation group was higher than the control group; the left ventricular end-systolic volume and left ventricular end-diastolic dimension were lower in both groups than before treatment

and those of the observation group were lower than the control group

with statistically significant differences（P<0.05）. At 1 month and 3 months of treatment

the QT dispersion and corrected QT dispersion were shorter in both groups than before treatment

and those of the observation group were shorter than the control group; the standard deviation of sinus R-R interval and the standard deviation of per 5 min mean sinus R-R interval were longer in both groups than before treatment

and those of the observation group were longer than the control group; the serum TGF-β1 and Smad2 levels were lower in both groups than before treatment

and those of the observation group were lower than the control group

with statistically significant differences（P<0.05）. By the one-way analysis of variance

the serum TGF-β1 and Smad2 levels tended to decrease as the clinical efficacy improved（P<0.05）; by the Spearman’s rank correlation coefficient analysis

the serum TGF-β1 and Smad2 levels were negatively correlated with the clinical efficacy（P<0.05）. The incidence of adverse drug reactions of the observation group was 11.11%（7/63）

compared with 9.68%（6/62） in the control group

the difference was not statistically significant（P>0.05）. CONCLUSIONS: Amiodarone combined with sakubatril valsartan in the treatment of DCM combined with CA can further improve patients’ cardiac rhythm and cardiac function

regulate the activity of TGF-β1/Smads signaling pathway

with significant effect and high safety.