Effect of magnesium sulfate on ventricular rate control in atrial fibrillation.
OBJECTIVE
The objectives of this study were to assess the efficacy of parenteral magnesium sulfate (MgSO4), digoxin, and combined MgSO4-digoxin therapies in acutely lowering ventricular rates in patients with newly recognized atrial fibrillation.


METHODS
A randomized, double-blinded, placebo-controlled clinical study.


METHODS
US Army tertiary care facility.


METHODS
Fifteen adults (mean age, 62 +/- 19 years) presenting with newly recognized atrial fibrillation and rapid ventricular rate (more than 99).


METHODS
Patients were given an initial parenteral MgSO4 bolus with continuous infusion or placebo. After 30 minutes, all patients were given 0.5 mg IV digoxin and followed for 3.5 hours.


RESULTS
Ventricular rates were obtained at baseline, every 5 minutes for the first 30 minutes, and then every 30 minutes for 3.5 hours. At 5 minutes, ventricular rates decreased 16 +/- 7% (P < .02) with MgSO4; this was comparable with rate control with digoxin (18 +/- 9%) at 4 hours. Rate control tended (26 +/- 7%) to improve with combined therapy.


CONCLUSIONS
Parenteral MgSO4 may be useful in the acute management of rapid ventricular rates in patients with atrial fibrillation.
Hays
J V
JV
Brooke Army Medical Center, Cardiology Service, Fort Sam Houston, Texas.
Gilman
J K
JK
Rubal
B J
BJ
D000368:Aged; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004077:Digoxin / Q000494:pharmacology / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008278:Magnesium Sulfate / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D004077:Digoxin; D008278:Magnesium Sulfate