Digitalis toxicity and hypomagnesemia

Seller, Robert H.; Cangiano, José L.; Kim, Kwan E.; Mendelssohn, Saul; Brest, Albert N.; Swartz, Charles

doi:10.1016/0002-8703(70)90394-7

Cited by 158 publications

(11 citation statements)

References 16 publications

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“…25 In contrast, hypomagnesemia increases the dose of digoxin required for rate control, 26 and lowers the threshold for digoxin-related arrhythmias. 27 In small metabolic unit studies, restriction of dietary magnesium to less than one-half of the recommended daily allowance increased supraventricular ectopy 28 and risk of AF. 29 Another recent study reported an inverse relation between magnesium status and sudden cardiac death, potentially lending further support to the link between hypomagnesemia and cardiac arrhythmias.…”

Section: Discussionmentioning

confidence: 99%

Low Serum Magnesium and the Development of Atrial Fibrillation in the Community

et al. 2013

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Background Low serum magnesium has been linked to increased risk of atrial fibrillation (AF) following cardiac surgery. It is unknown whether hypomagnesemia predisposes to AF in the community. Methods and Results We studied 3,530 participants (mean age, 44 years; 52% women) from the Framingham Offspring Study who attended a routine examination, and were free of AF and cardiovascular disease. We used Cox proportional hazard regression analysis to examine the association between serum magnesium at baseline and risk of incident AF. Analyses were adjusted for conventional AF risk factors, use of antihypertensive medications, and serum potassium. During up to 20 years of follow-up, 228 participants developed AF. Mean serum magnesium was 1.88 mg/dl. The age- and sex-adjusted incidence rate of AF was 9.4 per 1,000 person-years (95% confidence interval, 6.7 to 11.9) in the lowest quartile of serum magnesium (≤1.77 mg/dl), compared with 6.3 per 1,000 person-years (95% confidence interval, 4.1 to 8.4) in the highest quartile (≥1.99 mg/dl). In multivariable-adjusted models, individuals in the lowest quartile of serum magnesium were approximately 50% more likely to develop AF (adjusted hazard ratio, 1.52, 1.00 to 2.31; P=0.05), compared with those in the upper quartiles. Results were similar after excluding individuals on diuretics. Conclusion Low serum magnesium is moderately associated with the development of AF in individuals without cardiovascular disease. Because hypomagnesemia is common in the general population, a link with AF may have potential clinical implications. Further studies are warranted to confirm our findings and elucidate the underlying mechanisms.

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Section: Discussionmentioning

confidence: 99%

Low Serum Magnesium and the Development of Atrial Fibrillation in the Community

et al. 2013

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“…An increased susceptibility to digitalis intoxication has been observed both clinically and experimentally in magnesium deficiency (79)(80)(81). It has been suggested that this is due to an enhanced effect of digitalis on intracel lular potassium depletion (81).…”

Section: Manifestationsmentioning

confidence: 99%

Magnesium Deficiency and Excess

Rude¹,

Singer²

1981

Annu. Rev. Med.

191

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“…Only a 15% increase of heart rate^nd a slight deĴ crease in the P-R and Q-T intervals were observed (159). During prolonged dialysis of more than 3-6 hours, the electrocardiographic changes associated with hypomagnesaemia per se were S-T segment depression and T-wave Inversion (160). It should be mentioned that none of the authors found a definite correlation of the electrocardiographic changes with the extent of hypomagnesaemia.…”

Section: Cardiac Arrhythmie and Electrocardiogram In Hypomagnesaemiamentioning

confidence: 91%

“…Chronic äs well äs acute Mg 2 * deficient dogs show an increased sensitivity to cardiac glycosides, äs characterized by a lowered threshold dose for toxic arrhythmia (157,160,161) or by a proloriged duration of digitalis poisoning (162). By recourse to parenteral administration of Mg^" 1 " in dogs rnade acutely Mg 2+ deficient via haemodialysis, the cardiac glycoside-induced arrhythmia could be immediately revef sed into sinus rhythm (160).…”

Section: Cardiac Arrhythmie and Electrocardiogram In Hypomagnesaemiamentioning

confidence: 99%

“…By recourse to parenteral administration of Mg^" 1 " in dogs rnade acutely Mg 2+ deficient via haemodialysis, the cardiac glycoside-induced arrhythmia could be immediately revef sed into sinus rhythm (160). Also, in normomagnesaemic dogs, cardiac glycoside-induced ventricülar tachycardia coüld be converted into sinus rhythm by Mg 2 * infusion (163,164).…”

Section: Cardiac Arrhythmie and Electrocardiogram In Hypomagnesaemiamentioning

confidence: 99%

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