Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis

Abstract

Objectives: To assess the efficacy of the administration of magnesium as a method for the prevention of postoperative atrial fibrillation (AF) and to evaluate its influence on hospital length of stay (LOS) and mortality. Methods: Literature search and meta-analysis of the randomised control studies published since 1966. Results: 20 randomised trials were identified, enrolling a total of 2490 patients. Study sample size varied between 20 and 400 patients. Magnesium administration decreased the proportion of patients developing postoperative AF from 28% in the control group to 18% in the treatment group (odds ratio 0.54, 95% confidence interval (CI) 0.38 to 0.75). Data on LOS were available from seven trials (1227 patients). Magnesium did not significantly affect LOS (weighted mean difference 20.07 days of stay, 95% CI 20.66 to 0.53). The overall mortality was low (0.7%) and was not affected by magnesium administration (odds ratio 1.22, 95% CI 0.39 to 3.77). Conclusion: Magnesium administration is an effective prophylactic measure for the prevention of postoperative AF. It does not significantly alter LOS or in-hospital mortality.

Prophylactic Magnesium and Rhythm Disorders after Open Cardiac Surgery

“…Although the meta analysis by Miller et al [21] concluded that prophylactic administration of Mg is effective for prevention of AF after CABG, only 5 of the 20 studies included in the analysis were clearly in favor of Mg administration, with 7 studies showing no reduction in AF with Mg prophylaxis. We agree with his conclusion as our study also showed a clear reduction in incidence of postoperative atrial fibrillation with prophylactic intravenous magnesium administration.…”

Ivabradine Versus Beta-Blockers in Patients with Conduction Abnormalities or Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Grafting

“…A meta-analysis of randomized trials showed that prophylactic i.v. magnesium reduced the probability of postoperative atrial fibrillation (Miller et al, 2005). From the non-pharmacologic interventions investigated for atrial fibrillation prevention in the postoperative setting, prophylactic atrial pacing reduced the incidence of post-operative atrial fibrillation regardless of the atrial pacing site or pacing algorithm used, (Burgess et al, 2006; but results are controversial.…”

Fibrilação atrial no pós-operatório de cirurgia cardíaca

“…This effect is due to the fact that magnesium is a co-factor of the sodium potassium ATPase enzyme that regulates the transmembrane gradient of sodium and potassium ions. In their metanalysis, Miller et al 57 revealed a reduction in POAF incidence from 28% to 18%.…”