Annals of Emergency Medicine
Volume 45, Issue 4 , Pages 347-353 , April 2005

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

  • Michael John Davey, MBBS, FACEM

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Michael John Davey, MBBS, FACEM, Emergency Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia, Australia 5000; 61-08-8222-5063, fax 61-08-8222-4970
  • ,
  • David Teubner, MBBS, FACEM

Received 22 April 2004 ,Revised 9 September 2004 ,Accepted 15 September 2004.

References 

  1. Kannel WB, Abbott RD, Savage DD, et al. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982;306:1018–1022
  2. Alam M, Thorstrand C. Left ventricular function. Am J Cardiol. 1992;69:694–696
  3. Packer DL, Bardy GH, Worley SJ, et al. Tachycardia-induced cardiomyopathy: a reversible form of left ventricular dysfunction. Am J Cardiol. 1986;57:562–570
  4. Falk RH. Atrial fibrillation. N Engl J Med. 2001;344:1067–1078
  5. Falk RH. Management of atrial fibrillation: radical reform or modest modification. N Engl J Med. 2002;347:1883–1884
  6. American College of Cardiology/American Heart Association Task Force on Practice Guidelines/European Society of Cardiology Committee for Practice Guidelines and Policy Conferences . ACC/AHA/ESC Guidelines for the management of patients with atrial fibrillation: task force report. Eur Heart J. 2001;22:1852–1923
  7. Atkins DL, Dorian P, Gonzales ER, et al. Treatment of tachyarrhythmias. Ann Emerg Med. 2001;37:S91–S109
  8. Roberts SA, Zbrozek AS, Diaz C, et al. Digoxin treatment for atrial fibrillation and flutter: outcomes and costs. [abstract] Clin Res. 1992;40:751A
  9. Digitalis in Acute Atrial Fibrillation Trial Group . Intravenous digoxin in acute atrial fibrillation: results of a randomised, placebo controlled multi-center trial in 239 patients. Eur Heart J. 1997;18:649
  10. Schreck DM, Rivera AR, Tricario VJ. Emergency management of atrial fibrillation and flutter: intravenous diltiazem versus intravenous digoxin. Ann Emerg Med. 1997;29:135–140
  11. Connolly SJ. Evidence-based analysis of amiodarone efficacy and safety. Circulation. 1999;100:2025–2034
  12. DiCarli C, Sprouse G, La Rosa J. Serum magnesium levels in symptomatic atrial fibrillation and their relation to rhythm control by intravenous digoxin. Am J Cardiol. 1986;57:956–959
  13. Iseri LT, Allen BJ, Ginkel ML, et al. Ionic biology and ionic medicine in cardiac arrhythmias with particular reference to magnesium. Am Heart J. 1992;123:1404–1409
  14. Hasegawa J, Matsumoto T, Takami T, et al. Suppression of catecholamine induced abnormal pacemaker activities by magnesium ion in guinea pig cardiac muscle cells. Magnesium. 1989;8:94–99
  15. Kulic D, Hong R, Ryzen E, et al. Electrophysiologic effects of intravenous magnesium in patients with normal conduction systems and no clinical evidence of significant heart disease. Am Heart J. 1988;115:367–373
  16. Durlach J, Durlach V, Bac P, et al. Magnesium and therapeutics. Magnesium Res. 1994;7:313–328
  17. Olinger ML. Disorders of calcium and magnesium metabolism. Emerg Med Clin North Am. 1989;7:795–820
  18. Mclean RM. Magnesium and its therapeutic uses: a review. Am J Med. 1994;96:63–76
  19. Graves C. Agents that cause contraction or relaxation of the uterus. In:  Gilman AG,  Goodman LS,  Gilman A editor. The Pharmacological Basis of Therapeutics. 9th ed.. New York, NY: McGraw-Hill; 1996;p. 946–947
  20. Janson CL. Clinical Reviews: Hypermagnesemia. Micromedex, Poisindex, Vol. 99 [CD ROM].
  21. Rasmisen HS, Larson OG, Meier K, et al. Haemodynamic effects of intravenously administered magnesium on patients with ischemic heart disease. Clin Cardiol. 1988;11:824–828
  22. Walker S, Taylor J, Harrod R. The acute effects of magnesium in atrial fibrillation and flutter with a rapid ventricular rate. Emerg Med. 1996;8:207–213
  23. Moran J, Gallagher S, Peak S, et al. Parenteral magnesium sulphate versus amiodarone in the therapy of atrial tachyarrhythmias: a prospective, randomised study. Crit Care Med. 1995;23:1816–1824
  24. Hays J, Gilman J, Rubal B. Effect of magnesium sulphate on ventricular rate control in atrial fibrillation. Ann Emerg Med. 1994;24:61–64
  25. Brodsky M, Orlov M, Capparelli E, et al. Magnesium therapy in new onset atrial fibrillation. Am J Cardiol. 1994;73:1227–1229
  26. Gullestad L, Birkeland K, Milstad P, et al. The effect of magnesium versus verapamil on supraventricular arrhythmias. Clin Cardiol. 1993;16:429–434
  27. Eray O, Arca S, Pekdemir M, et al. Magnesium efficacy in magnesium deficient and non-deficient patients with rapid ventricular response atrial fibrillation. Eur J Emerg Med. 2000;7:287–290
  28. Chiladakis J, Stathopoulos C, Davlouros P, et al. Intravenous magnesium sulphate versus diltiazem in paroxysmal atrial fibrillation. Int J Cardiol. 2001;79:287–291
  29. Dyckner T, Wester PO. Ventricular extrasystoles and intracellular electrolytes before and after potassium and magnesium infusion in patients on diuretic treatment. Am Heart J. 1979;97:12–18
  30. Ryzen E, Elkayam U, Rude RK. Low blood mononuclear cell magnesium in intensive cardiac unit patients. Am Heart J. 1986;111:475–480

 Author contributions: MJD conceived and designed the study. MJD and DT collected and analyzed the data and wrote the manuscript. MJD takes responsibility for the paper as a whole.

 Funding and support: The authors report this study did not receive any outside funding or support.

 Reprints not available from the authors.

PII: S0196-0644(04)01431-3

doi: 10.1016/j.annemergmed.2004.09.013

Annals of Emergency Medicine
Volume 45, Issue 4 , Pages 347-353 , April 2005