Key result
A 4 g preoperative magnesium infusion did not significantly change thromboelastographic coagulation parameters or convert atrial fibrillation to sinus rhythm in patients undergoing mitral valve annuloplasty.
Why the study?
Does magnesium infusion decrease the incidence of AF and induce a hypocoagulable state in patients with AF undergoing mitral valve annuloplasty?
Does magnesium infusion decrease the incidence of AF and induce a hypocoagulable state in patients with AF undergoing mitral valve annuloplasty?
A 4g magnesium infusion prior to cardiopulmonary bypass does not alter coagulation parameters or convert atrial fibrillation to sinus rhythm in patients undergoing mitral valve annuloplasty.
Answers are grounded in this paper and cite their sources.
No support for magnesium altering coagulation or converting AF; leaves open need for randomized trials in mitral surgery.
BACKGROUND: Atrial fibrillation (AF) is the most common cardiac arrhythmia. Magnesium has been reported to be effective in reducing the incidence or prophylaxis of AF. Magnesium is also an essential constituent of many enzyme systems and plays a physiological role in coagulation regulation. The aim of the present study was to examine the effects of magnesium, whether magnesium infusion might decrease the incidence of AF and induce hypocoagulable state in patients with AF, who were undergoing mitral valve annuloplasty. METHODS: This prospective laboratory study was performed using blood from patients with AF undergoing mitral valve annuloplasty. The radial artery was punctured with a 20 gauge catheter and used for monitoring continuous arterial pressure and blood sampling. After anesthesia induction, 4 g of magnesium was mixed with 100 ml normal saline and infused for 5 minutes. Magnesium, calcium, activated clotting time (ACT) and thromboelastographic parameters were checked before and 60 minutes after the magnesium infusion. The electrocardiography changes after magnesium infusion were also checked before commencing cardiopulmonary bypass. RESULTS: After magnesium infusion, the serum level of magnesium increased significantly but serum calcium did not change significantly. ACT did not change significantly before or after magnesium infusion. The thromboelastographic parameters showed no significant changes before or after magnesium infusion. None of the patients converted to sinus rhythm from AF after the magnesium infusion. CONCLUSIONS: A magnesium infusion did not influence the course of AF and coagulation in patients during prebypass period with AF undergoing mitral valve annuloplasty.
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Kang et al. (2011) studied Atrial fibrillation (n=35). Magnesium vs. Baseline was evaluated on Clotting time (CT) on thromboelastography (p=0.70). A 4 g preoperative magnesium infusion did not significantly change thromboelastographic coagulation parameters or convert atrial fibrillation to sinus rhythm in patients undergoing mitral valve annuloplasty.
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