Efficacy of intravenous magnesium for the management of non-post operative atrial fibrillation with rapid ventricular response: A systematic review and meta-analysis.

Enayati, Anees; Gin, Julian H; Sajeev, Jithin K; Cooke, Jennifer C; Carey, Patrick; MacPherson, Michael; Roberts, Louise; Buntine, Paul; Teh, Andrew W; Nogic, Jason

doi:10.1111/jce.15911

Title

Efficacy of intravenous magnesium for the management of non-post operative atrial fibrillation with rapid ventricular response: A systematic review and meta-analysis.

Publication Date

2023-05

Author(s)

Enayati, Anees

Gin, Julian H

Sajeev, Jithin K

Cooke, Jennifer C

Carey, Patrick

MacPherson, Michael

Roberts, Louise

Buntine, Paul

Teh, Andrew W

Nogic, Jason

Subject

atrial fibrillation

intravenous magnesium

Type of document

Journal Article

OrcId

0000-0002-1257-5739

0000-0002-5365-2008

#PLACEHOLDER_PARENT_METADATA_VALUE#

DOI

10.1111/jce.15911

Abstract

Intravenous magnesium (IV Mg), a commonly utilized therapeutic agent in the management of atrial fibrillation (AF) with rapid ventricular response, is thought to exert its influence via its effect on cellular automaticity and prolongation of atrial and atrioventricular nodal refractoriness thus reducing ventricular rate. We sought to undertake a systematic review and meta-analysis of the effectiveness of IV Mg versus placebo in addition to standard pharmacotherapy in the rate and rhythm control of AF in the nonpostoperative patient cohort given that randomized control trials (RCTs) have shown conflicting results. Randomized controlled trials comparing IV Mg versus placebo in addition to standard of care were identified via electronic database searches. Nine RCTs were returned with a total of 1048 patients. Primary efficacy endpoints were study-defined rate control and rhythm control/reversion to sinus rhythm. The secondary endpoint was patient experienced side effects. Our analysis found IV Mg in addition to standard care was successful in achieving rate control (odd ratio [OR] 1.87, 95% confidence interval [CI] 1.13-3.11, p = .02) and rhythm control (OR 1.45, 95% CI 1.04-2.03, p = .03). Although not well reported among studies, there was no significant difference between groups regarding the likelihood of experiencing side effects. IV Mg, in addition to standard-of-care pharmacotherapy, increases the rates of successful rate and rhythm control in nonpostoperative patients with AF with rapid ventricular response and is well tolerated.

Link

link

Citation

Journal of Cardiovascular Electrophysiology 2023-05; 34(5)

Jornal Title

Journal of Cardiovascular Electrophysiology

ISSN

1540-8167

Austin Health

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