Key result
Intravenous magnesium sulphate significantly decreased heart rate at 30 minutes compared to placebo (24.1/min vs 11.0/min) but had no effect on reversion to sinus rhythm at four hours.
Why the study?
Does intravenous magnesium sulphate reduce ventricular rate and improve reversion to sinus rhythm in patients presenting to the emergency department with rapid atrial fibrillation and flutter?
RCT (n=41)
Double-blind
Randomized
Does intravenous magnesium sulphate reduce ventricular rate and improve reversion to sinus rhythm in patients presenting to the emergency department with rapid atrial fibrillation and flutter?
Intravenous magnesium sulphate provides significant acute slowing of the ventricular rate in rapid atrial fibrillation and flutter but does not increase the rate of reversion to sinus rhythm.
Supports IV magnesium for acute rate control in ED rapid AF/flutter; challenges its use for rhythm reversion.
A prospective, randomised, placebo controlled, double blinded trial to assess the efficacy of intravenous magnesium sulphate (20mmol over 30 minutes) versus placebo in patients presenting to the emergency department with rapid atrial fibrillation and flutter. The end points were slowing of the ventricular rate and reversion to sinus rhythm. A total of 41 patients were enrolled. The mean decrease in heart rate 30 minutes after commencing the infusion was 24.1/min for the magnesium group compared to 11.0/min for the placebo group (different at the 95% level of significance). The mean decrease in heart rate and the reversion rate four hours after commencing the infusion were the same at the 95% level of significance for the two groups. We conclude that magnesium has a significant effect in the acute slowing of ventricular rate but no effect in achieving reversion to sinus rhythm.
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Walker et al. (1996) conducted an RCT in Rapid atrial fibrillation and flutter (n=41). Intravenous magnesium sulphate vs. Placebo was evaluated on Slowing of the ventricular rate and reversion to sinus rhythm (p=<0.05). Intravenous magnesium sulphate significantly decreased heart rate at 30 minutes compared to placebo (24.1/min vs 11.0/min) but had no effect on reversion to sinus rhythm at four hours.
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