Antiarrhythmic effect of magnesium sulfate after open heart surgery: effect of blood levels


Kiziltepe U., Eyileten Z., Sirlak M., Tasoz R., Aral A., Eren N., ...Daha Fazla

INTERNATIONAL JOURNAL OF CARDIOLOGY, cilt.89, sa.2-3, ss.153-158, 2003 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 89 Sayı: 2-3
  • Basım Tarihi: 2003
  • Doi Numarası: 10.1016/s0167-5273(02)00449-7
  • Dergi Adı: INTERNATIONAL JOURNAL OF CARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.153-158
  • Anahtar Kelimeler: antiarrhythmic effect, magnesium sulfate, open-heart surgery, blood levels, CORONARY-ARTERY, ATRIAL-FIBRILLATION, CARDIAC OPERATIONS, PROPHYLAXIS, CHANNELS
  • Ankara Üniversitesi Adresli: Evet

Özet

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. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.