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The Annals of Thoracic Surgery, Vol 52, 529-533, Copyright © 1991 by The Society of Thoracic Surgeons
WJ Fanning, CS Thomas Jr, A Roach, R Tomichek, WC Alford and WS Stoney Jr
Ninety-nine consecutive consenting patients were prospectively entered into
a randomized, double-blind, placebo-controlled trial to determine the
efficacy of postoperative magnesium therapy on the incidence of cardiac
arrhythmias after elective coronary artery bypass grafting. No patient had
documented or suspected arrhythmias preoperatively. Forty- nine patients
received 178 mEq of magnesium given over the first 4 postoperative days,
and 50 patients received only placebo. The clinical characteristics of both
groups were similar. The preoperative mean serum magnesium concentration
was similar in both study (1.90 mEq/L) and placebo (1.90 mEq/L) groups. The
mean postoperative serum magnesium concentration in study patients was
significantly elevated over postoperative days 1 through 4 when compared
with preoperative levels (p less than 0.001). The postoperative mean serum
magnesium concentration in control patients declined and remained
significantly depressed through postoperative day 3 (p less than 0.001),
but increased to preoperative levels by postoperative day 4. The mean serum
magnesium concentration was significantly greater in the study patients as
compared with the control patients over postoperative days 1 through 4 (p
less than 0.001). Although there was no significant difference between
groups with respect to episodes of ventricular arrhythmias, there was a
significant decrease in the number of episodes of atrial fibrillation in
the group receiving magnesium therapy (p less than 0.02). There were no
recognized adverse effects of magnesium therapy. Prophylactic magnesium
administration seems to lessen the incidence and severity of atrial
fibrillation after coronary artery bypass grafting.
ARTICLES
Prophylaxis of atrial fibrillation with magnesium sulfate after coronary artery bypass grafting
Department of Cardiac and Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
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