title: Antiarrhythmic effect of magnesium sulfate after open heart surgery: effect of blood levels.
abstract: BACKGROUND
  Arrhythmias following cardiac surgery is still a difficult complication to treat. Magnesium sulfate is an effective antiarrhythmic agent with negligible side effects. In this study, effects of magnesium sulfate as a first line antiarrhythmic agent was compared with results of two different well-accepted antiarrhythmic agents.
  
  
  METHODS
  One hundred patients with arrhythmia were prospectively randomized to a study and a control group. Lidocaine and amiodarone were accepted as standard antiarrhythmic agents. Patients in study group were received magnesium sulfate routinely as a first line antiarrhythmic agent. Unresponsive arrhythmias were treated with standard antiarrhythmic agents. Control group patients received only standard antiarrhythmics.
  
  
  RESULTS
  Magnesium sulfate alone was effective in 56% of the study group whereas 74% of the control group were responsive to standard antiarrhythmics (P=n.s.). In study group, a subgroup analysis according to blood levels of Mg2+ revealed that magnesium sulfate was more effective in patients with low Mg2+ levels (63% for low Mg2+ levels, 55% for normal Mg2+ levels, 36% for high Mg2+ levels) and ventricular arrhythmias (60% for ventricular and 40% for supraventricular arrhythmias), without statistical significance.
  
  
  CONCLUSIONS
  Magnesium sulfate is an effective and safe antiarrhythmic agent for arrhythmias developed after open-heart surgery. Its antiarrhythmic effect may relate to its pharmacological properties and unrelated to normalization of the circulating magnesium concentrations. We recommend its use as a first line antiarrhythmic agent without routine measurement of blood levels.
authors.affiliation: Department of Cardiovascular Surgery, Ankara University School of Medicine, Ankara, Turkey. uk9316@hotmail.com <uk9316@hotmail.com>
authors.forename: Ugursay
authors.initials: U
authors.lastname: Kiziltepe
authors.forename: Zeynep Bastuzel
authors.initials: ZB
authors.lastname: Eyileten
authors.forename: Mustafa
authors.initials: M
authors.lastname: Sirlak
authors.forename: Refik
authors.initials: R
authors.lastname: Tasoz
authors.forename: Atilla
authors.initials: A
authors.lastname: Aral
authors.forename: Neyyir Tuncay
authors.initials: NT
authors.lastname: Eren
authors.forename: Adnan
authors.initials: A
authors.lastname: Uysalel
authors.forename: Hakki
authors.initials: H
authors.lastname: Akalin
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000209:etiology*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008274:Magnesium / Q000097:blood*; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D008278:Magnesium Sulfate; D008012:Lidocaine; D008274:Magnesium; D000638:Amiodarone