A Randomized Controlled Trial of Magnesium Sulfate, in Addition to Usual Care, for Rate Control in Atrial Fibrillation

Davey, Michael; Teubner, David John Osmond

doi:10.1016/j.annemergmed.2004.09.013

Cited by 52 publications

(37 citation statements)

References 24 publications

(26 reference statements)

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“…Their meta-analysis pooled four trials (303 patients) and eight trials (476 patients), respectively, for acute rate control (<100 beats ⁄ min) and rhythm control and included the trials by Davey and Teubner 5 and Walker et al 11 The therapies against which magnesium was compared in these pooled trials were varied. Magnesium or placebo was given in addition to standard therapy.…”

Section: Discussionmentioning

confidence: 99%

“…More commonly, previous investigators have compared magnesium in addition to standard therapy against standard therapy alone. Standard therapies have included a variety of antiarrhythmic agents including digoxin, [3][4][5]11 verapamil, 6,7 diltiazem, 8 and amiodarone. 12 These studies have all reported apparent benefits of magnesium in the treatment of supraventricular tachyarrhythmias, including AF.…”

Section: Discussionmentioning

confidence: 99%

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Magnesium Sulfate versus Placebo for Paroxysmal Atrial Fibrillation: A Randomized Clinical Trial

Chu¹,

Evans²,

Emerson³

et al. 2009

Academic Emergency Medicine

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Objectives: The objective was to investigate the efficacy of magnesium sulfate (MgSO 4 ) in decreasing the ventricular rate in emergency department (ED) patients presenting with new-onset, rapid atrial fibrillation (AF).Methods: A double-blinded, placebo-controlled randomized clinical trial was conducted in an adult university hospital. Patients aged ‡18 years with AF onset of less than 48 hours and a sustained ventricular rate of >100 beats ⁄ min were randomized to either intravenous (IV) MgSO 4 10 mmol or normal saline (NSal). Rhythm and instantaneous heart rate as measured by the monitor were recorded at baseline and every 15 minutes for 2 hours after starting the trial drug. Heart rate and rhythm were compared at 2 hours. A multilevel modeling analysis was performed to adjust for differences in baseline heart rate and any additional treatment and to examine changes in heart rate over time.Results: Twenty-four patients were randomized to MgSO 4 and 24 to NSal. Baseline heart rate was lower in the MgSO 4 group (mean ± standard deviation [±SD] = 125 ± 24 vs. 140 ± 21 beats ⁄ min]. One and 3 patients in the MgSO 4 and NSal groups, respectively, were given another antiarrhythmic or were electrically cardioverted within 2 hours after starting the trial drug. Heart rate (mean ± SD) at 2 hours in both MgSO 4 (116 ± 30 beats ⁄ min) and NSal groups (114 ± 31 beats ⁄ min) decreased below their respective baseline levels. However, the rate of heart rate decrease across time did not differ between groups (p = 0.124). The proportion of patients who converted to sinus rhythm 2 hours post-trial drug did not differ (MgSO 4 8.7% vs. NSal 25.0%, p = 0.25).Conclusions: This study was unable to demonstrate a difference between IV MgSO 4 10 mmol and saline placebo for reducing heart rate or conversion to sinus rhythm at 2 hours posttreatment in ED patients with AF of less than 48 hours duration.ACADEMIC EMERGENCY MEDICINE 2009; 16:295-300 ª

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Magnesium Sulfate versus Placebo for Paroxysmal Atrial Fibrillation: A Randomized Clinical Trial

Chu¹,

Evans²,

Emerson³

et al. 2009

Academic Emergency Medicine

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“…13 In 199 patients receiving rate control for rapid AF (again mostly with digoxin), those randomized to intravenous supplemental magnesium were more likely to reach a rate of <100 beats per minute at 2 hours (relative risk, 1.89; 95% confidence interval, 1.38-2.59). 19 Although these results are encouraging, magnesium has not been widely adopted as a rate control strategy, as more effective agents are available for acute ventricular rate control, such as β-blockers, verapamil, and diltiazem.…”

Section: See Article By Rajagopalan Et Almentioning

confidence: 99%

Magnesium for Atrial Fibrillation, Myth or Magic?

Kotecha

2016

Circ: Arrhythmia and Electrophysiology

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“…325 Most studies showed no conversion benefit for magnesium (LOE 1), 327,328 although 1 meta-analysis showed conversion benefit (LOE 1). 329 Most studies showed a benefit for magnesium in rate control (LOE 1), 295,329,330 although 1 study was neutral for magnesium for rate control (LOE 1). 328 Quinidine has been shown to have greater conversion than sotalol in 2 studies (LOE 1), 331,332 although this was with greater toxicity.…”

Section: Consensus On Sciencementioning

confidence: 99%