title: Intravenous administration of magnesium and potassium solution lowers energy levels and increases success rates electrically cardioverting atrial fibrillation.
abstract: BACKGROUND
  External biphasic electrical cardioversion (CV) is a standard treatment option for patients suffering from acute symptoms of atrial fibrillation (AF). Nevertheless, CV is not always successful, and thus strategies to increase the success rate are desirable.
  
  
  OBJECTIVE
  The purpose of this study was to evaluate the effect of intravenously administered K/Mg solution on the biphasic CV energy threshold and success rate to restore sinus rhythm (SR) in patients with AF.
  
  
  METHODS
  The study consisted of 170 patients with persistent AF. The patients were randomly assigned to undergo biphasic CV either with (n = 84) or without (n = 86) pretreatment with K/Mg solution. An energy step-up protocol of 75, 100, and 150 W (J) was used.
  
  
  RESULTS
  Biphasic CV of AF was effective in 81 (96.4%) patients in the pretreatment and 74 (86.0%) patients in the control group (P = 0.005). The effective energy level required to achieve SR was significantly lower in the pretreated group (140.8 ± 26.9 J vs 182.5 ± 52.2 J, P = 0.02). No K/Mg-solution-associated side effects such as hypotension or bradycardia were observed.
  
  
  CONCLUSIONS
  Administration of K/Mg solution positively influences the success rate of CV in patients with persistent AF. Furthermore, significantly less energy is required to successfully restore SR and therefore K/Mg pretreatment may facilitate SR restoration in patients undergoing CV for AF.
authors.affiliation: Cardiac Electrophysiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany. asultan@uke.de
authors.forename: Arian
authors.initials: A
authors.lastname: Sultan
authors.forename: Daniel
authors.initials: D
authors.lastname: Steven
authors.forename: Thomas
authors.initials: T
authors.lastname: Rostock
authors.forename: Boris
authors.initials: B
authors.lastname: Hoffmann
authors.forename: Kai
authors.initials: K
authors.lastname: Müllerleile
authors.forename: Helge
authors.initials: H
authors.lastname: Servatius
authors.forename: Imke
authors.initials: I
authors.lastname: Drewitz
authors.forename: Jakob
authors.initials: J
authors.lastname: Lüker
authors.forename: Philip
authors.initials: P
authors.lastname: Meyer
authors.forename: Tushar
authors.initials: T
authors.lastname: Salukhe
authors.forename: Stephan
authors.initials: S
authors.lastname: Willems
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003131:Combined Modality Therapy; D047548:Defibrillators; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005858:Germany; D006801:Humans; D007262:Infusions, Intravenous; D008274:Magnesium / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D008274:Magnesium; D011188:Potassium