Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis.
OBJECTIVE
To assess the efficacy of the administration of magnesium as a method for the prevention of postoperative atrial fibrillation (AF) and to evaluate its influence on hospital length of stay (LOS) and mortality.


METHODS
Literature search and meta-analysis of the randomised control studies published since 1966.


RESULTS
20 randomised trials were identified, enrolling a total of 2490 patients. Study sample size varied between 20 and 400 patients. Magnesium administration decreased the proportion of patients developing postoperative AF from 28% in the control group to 18% in the treatment group (odds ratio 0.54, 95% confidence interval (CI) 0.38 to 0.75). Data on LOS were available from seven trials (1227 patients). Magnesium did not significantly affect LOS (weighted mean difference -0.07 days of stay, 95% CI -0.66 to 0.53). The overall mortality was low (0.7%) and was not affected by magnesium administration (odds ratio 1.22, 95% CI 0.39 to 3.77).


CONCLUSIONS
Magnesium administration is an effective prophylactic measure for the prevention of postoperative AF. It does not significantly alter LOS or in-hospital mortality.
Miller
S
S
Arrhythmia Services, Schulich Heart Centre, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Crystal
E
E
Garfinkle
M
M
Lau
C
C
Lashevsky
I
I
Connolly
S J
SJ
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007902:Length of Stay; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D019616:Thoracic Surgical Procedures / Q000401:mortality
D000889:Anti-Arrhythmia Agents; D008278:Magnesium Sulfate