Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
The influence of intravenous magnesium sulphate on the occurrence of atrial fibrillation after coronary artery by-pass operation
First Department of Medicine, Helsinki University Central Hospital Helsinki, Finland
*Department of Thoracic and Cardiovascular Surgery, Helsinki University Central Hospital Helsinki, Finland
Received 4 June 1992; revised 13 July 1992; .
Correspondence Dr Hannu Parikka, Cardiovascular Laboratory, First Department of Medicine, Helsinki University Central Hospital, Haartmaninkatu 4, 00290 Helsinki, Finland
Abstract
To examine the influence of (Mg) on hypomagnesaemia and atrial fibrillation (AF) following coronary artery by-pass surgery, 140 consecutive patients were randomized to receive 70 mmol of magnesium sulphate intravenously (n = 69) or placebo (n = 71). Serum magnesium concentrations fell to 0.77 ± 0.10 mmol. l–1 in the control group but rose to 1.09 ± 0.17 mmol. l–1 in the Mg group (P <0.001). The incidence of AF was 29% in the Mg group and 26% in the placebo group (NS). The AF patients were older, more of them had had prior AF episodes, their sinus rates (SR) were slower (78 ± 10 vs 86 ± 12 beats. Min–1; P <0.01) and serum Mg concentrations higher (0.89 ± 0.21 vs 0.11 mmol. l–1; P <0.05) The incidence of AF was 43% in the highest quartile of serum Mg and 23% among the rest (P = 0.056). In patients experiencing AF during the first three post-operative days, serum Mg concentrations were higher and SR slower on each day compared with non-AF patients. SR increased post-operatively less with high Mg levels (P = 0.044). In the Mg group, serum Mg and SR were the only independent predictors of AF. In conclusion, the incidence of post-operative AF is not decreased with magnesium. High Mg levels are likely to provoke AF probably by mechanisms that modify SR.
Key Words: Magnesium • atrial fibrillation • CABG • sinus rate
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