PARENTERALMAGNESIUMSULFATEIN THE TREATMENT OF ATRIAL FIBRILLATION

Abstract

The antiarrhythmic effect of magnesium sulfate have been known long ago particularly in ventricular tachycardia and in torsades de points. We are hereby reporting the results of l.V. Mgso4 in 30 patients (12 M, 18 F, mean age 54.6±8.12) with chronic AF (mean duration of 4.3 years). Underlying heart disease comprises: RHO in 9 patients, CAD in 5 and CM in 2 patients. The remaining patients had no underlying structural heart diseases following clinical evaluation all patients had an infusion of Mgso4 at a rate of 25mg/kg following a bolus of3Smg/kg. The infusion was continued for a mean of 12 hours, (ranging from 6-24 hours) with a total dose of Mg received averaging 19.3gm, (ranging from 10 to 40 gm). M-mode&2D echo were carried out before the study

to assess the cardiac dimensions, systolic and diastolic function . Of the 30 patients subjected to I.V. Mg infusion, 8 patients were successfully cardioverted to sinus rhythm over a mean period of 2 hours (ranging from 6 to 12 hours) while 10 patients had achieved rate control from a mean of 140/min to 90/min over a period of3 hours, (range from 12 to 24 hours). Twelve patients failed to respond. Compared to the non-responders the 8 successfully cardioverted patents had significantly smaller LA size and their mean duration of AF was 2 years. The Mgso4 bolus was associated with flushing and mild diaphoresis in all patients. These symptoms, however all resolved during the steady state infusion. In addition, one patient had transient hypotonia. No patients had change in the mental status, or any other adverse effects were reported during l.V. use of Mgso4.