Intravenous magnesium in the management of rapid atrial fibrillation: A systematic review and meta-analysis.

Autor: Ramesh T; Division of Cardiology, University of Cincinnati, Cincinnati, OH. Electronic address: rameshtr@ucmail.uc.edu., Lee PYK; Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ., Mitta M; Department of Emergency Medicine, Eastern Virginia Medical School, Norfolk, VA., Allencherril J; Texas Heart Institute at Baylor St. Luke's Medical Center, Houston, TX, USA.
Jazyk: angličtina
Zdroj: Journal of cardiology [J Cardiol] 2021 Nov; Vol. 78 (5), pp. 375-381. Date of Electronic Publication: 2021 Jun 20.
DOI: 10.1016/j.jjcc.2021.06.001
Abstrakt: Background: The aim of this meta-analysis is to investigate the effectiveness of intravenous magnesium (IV Mg 2+ ) in rate and rhythm control of rapid atrial fibrillation (AF) when administered in addition to standard-of-care for non-post-operative patients. Previous meta-analyses on this topic have demonstrated the efficacy of IV Mg 2+ in achieving rate control, but not rhythm control.
Methods: Six randomized controlled trials comparing IV Mg 2+ to placebo in the treatment of rapid AF were obtained from electronic databases totaling 745 patients. Outcomes were analyzed using a Mantel-Haenszel random-effects model and expressed as odds ratios (OR) for dichotomous outcomes with their 95% confidence intervals (CIs).
Results: Our pooled analysis showed that IV Mg 2+ given in addition to standard-of-care was superior in achieving rate control (63% vs 40%; OR 2.49, 95% CI 1.80-3.45) and rhythm conversion to sinus (21% vs. 14%, OR 1.75, 95% CI 1.08-2.84) compared to standard-of-care alone. Flushing was more frequently observed in patients receiving IV Mg 2+ compared to placebo (9% vs. 0.4%, OR 19.79, 95% CI 4.30-91.21). Subgroup analysis showed the superiority of a lower dose of IV Mg 2+ , which we designated as 5 g or lower (24% vs 13%, OR 2.10, 95% CI 1.22-3.61) compared to the higher dose (>5 g) (16% vs 13%, OR 1.23, 95% CI 0.65-2.32) in rhythm control when compared to placebo.
Conclusions: IV Mg 2+ administered in conjunction with standard-of-care is effective for rate control and modestly effective for restoration of sinus rhythm in rapid AF without clinically significant adverse effects.
Competing Interests: Disclosures The authors declare that there is no conflict of interest.
(Copyright © 2021. Published by Elsevier Ltd.)
Databáze: MEDLINE
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