Intravenous magnesium sulfate prophylaxis for atrial fibrillation after coronary artery bypass surgery.
OBJECTIVE
Atrial fibrillation is a rhythm disorder commonly seen early after coronary artery bypass grafting, and it increases morbidity.


METHODS
To investigate the effectiveness of magnesium sulfate in the prophylaxis of atrial fibrillation, we conducted a prospective, randomized, placebo-controlled clinical study on 200 consecutive patients in whom we performed elective and initial coronary artery bypass grafting operations. In each group 50% of patients underwent beating-heart operations. In the treatment group 100 patients (76 men and 24 women; mean age, 57.63 +/- 9.68 years) received 24.34 mEq (3 g) of magnesium sulfate in 100 mL of saline solution that was administered over 2 hours (50 mL/h) preoperatively, perioperatively, and at postoperative days 0, 1, 2, and 3. In the control group 100 patients (74 men and 26 women; mean age, 59.96 +/- 9.29 years) received only 100 mL of saline solution according to the same administration schedule as the treatment group.


RESULTS
Atrial fibrillation developed in 15 patients from the treatment group and in 16 patients from the control group. The arrhythmia developed after 37.87 +/- 12.76 and 45.26 +/- 15.27 hours in the treatment and control groups, respectively. Although a significant relationship was found between low magnesium sulfate levels and increased incidence of atrial fibrillation (P <.05), when the incidence of postoperative atrial fibrillation is concerned, no significant difference was found between the 2 groups (P >.05). Also, no significant difference was found between operations with cardiopulmonary bypass and beating-heart operations in terms of atrial fibrillation incidence (P >.05). However, atrial fibrillation extended the duration of hospital stay in both groups (P <.05).


CONCLUSIONS
Our findings indicate that magnesium sulfate infusion alone is not sufficient for the prophylaxis of atrial fibrillation.
Kaplan
Mehmet
M
Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. mehmetkaplan@superonline.com
Kut
Mustafa Sinan
MS
Icer
Umit Akif
UA
Demirtas
Mahmut Murat
MM
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000097:blood / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D016903:Drug Monitoring; D005260:Female; D006339:Heart Rate; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007902:Length of Stay / Q000706:statistics & numerical data; D008278:Magnesium Sulfate / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011188:Potassium / Q000097:blood; D011292:Premedication / Q000379:methods*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D008278:Magnesium Sulfate; D011188:Potassium