Cargando…

Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care

Several studies have suggested the potential role of Magnesium Sulfate (MgSO(4)) for the treatment of Atrial Fibrillation (AF) but, in clinical practice, the use of magnesium is not standardized although it is largely used for the treatment of supraventricular arrhythmias. Objectives. We evaluated t...

Descripción completa

Detalles Bibliográficos
Autores principales: Gilardi, Emanuele, Pomero, Fulvio, Ravera, Enrico, Piccioni, Andrea, Santoro, Michele Cosimo, Bonadia, Nicola, Carnicelli, Annamaria, Di Maurizio, Luca, Sabia, Luca, Longhitano, Yaroslava, Saviano, Angela, Ojetti, Veronica, Savioli, Gabriele, Zanza, Christian, Franceschi, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570780/
https://www.ncbi.nlm.nih.gov/pubmed/36233391
http://dx.doi.org/10.3390/jcm11195527
_version_ 1784810196005027840
author Gilardi, Emanuele
Pomero, Fulvio
Ravera, Enrico
Piccioni, Andrea
Santoro, Michele Cosimo
Bonadia, Nicola
Carnicelli, Annamaria
Di Maurizio, Luca
Sabia, Luca
Longhitano, Yaroslava
Saviano, Angela
Ojetti, Veronica
Savioli, Gabriele
Zanza, Christian
Franceschi, Francesco
author_facet Gilardi, Emanuele
Pomero, Fulvio
Ravera, Enrico
Piccioni, Andrea
Santoro, Michele Cosimo
Bonadia, Nicola
Carnicelli, Annamaria
Di Maurizio, Luca
Sabia, Luca
Longhitano, Yaroslava
Saviano, Angela
Ojetti, Veronica
Savioli, Gabriele
Zanza, Christian
Franceschi, Francesco
author_sort Gilardi, Emanuele
collection PubMed
description Several studies have suggested the potential role of Magnesium Sulfate (MgSO(4)) for the treatment of Atrial Fibrillation (AF) but, in clinical practice, the use of magnesium is not standardized although it is largely used for the treatment of supraventricular arrhythmias. Objectives. We evaluated the role of MgSO(4) infusion in association with flecainide in cardioversion of patients presenting in ED with symptomatic AF started less than 48 h before. We retrospectively searched for all patients presented in ED from 1 January 2019 to 31 December 2019 requiring pharmacological cardioversion with flecainide 2 mg/kg. Ninety-seven patients met these criteria, 46 received the administration of intravenous MgSO(4) 2 gr (Group A), and 51 did not (Group B). Among the 97 patients, the overall cardioversion rate was 85.6%, 91.3% in Group A and 80.4% in Group B. In 27 patients out of 97, the Flecainide was not administered because of spontaneous restoration of sinus rhythm of 9 pts (Group B) and 18 pts (Group A). We also found a statistical significance in the HR at the time of cardioversion between Group A (77.8 ± 19.1 bpm) and Group B (87 ± 21.7 bpm). No complications emerged. The association between MgSO(4) and Flecainide has not yielded statistically significant results. However, in consideration of its high safety profile, MgSO(4) administration may play a role in ED cardioversion of acute onset AF, reducing the need for antiarrhythmic medications and electrical cardioversion procedures, relieving symptoms reducing heart rate, and reducing the length of stay in the ED.
format Online
Article
Text
id pubmed-9570780
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95707802022-10-17 Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care Gilardi, Emanuele Pomero, Fulvio Ravera, Enrico Piccioni, Andrea Santoro, Michele Cosimo Bonadia, Nicola Carnicelli, Annamaria Di Maurizio, Luca Sabia, Luca Longhitano, Yaroslava Saviano, Angela Ojetti, Veronica Savioli, Gabriele Zanza, Christian Franceschi, Francesco J Clin Med Article Several studies have suggested the potential role of Magnesium Sulfate (MgSO(4)) for the treatment of Atrial Fibrillation (AF) but, in clinical practice, the use of magnesium is not standardized although it is largely used for the treatment of supraventricular arrhythmias. Objectives. We evaluated the role of MgSO(4) infusion in association with flecainide in cardioversion of patients presenting in ED with symptomatic AF started less than 48 h before. We retrospectively searched for all patients presented in ED from 1 January 2019 to 31 December 2019 requiring pharmacological cardioversion with flecainide 2 mg/kg. Ninety-seven patients met these criteria, 46 received the administration of intravenous MgSO(4) 2 gr (Group A), and 51 did not (Group B). Among the 97 patients, the overall cardioversion rate was 85.6%, 91.3% in Group A and 80.4% in Group B. In 27 patients out of 97, the Flecainide was not administered because of spontaneous restoration of sinus rhythm of 9 pts (Group B) and 18 pts (Group A). We also found a statistical significance in the HR at the time of cardioversion between Group A (77.8 ± 19.1 bpm) and Group B (87 ± 21.7 bpm). No complications emerged. The association between MgSO(4) and Flecainide has not yielded statistically significant results. However, in consideration of its high safety profile, MgSO(4) administration may play a role in ED cardioversion of acute onset AF, reducing the need for antiarrhythmic medications and electrical cardioversion procedures, relieving symptoms reducing heart rate, and reducing the length of stay in the ED. MDPI 2022-09-21 /pmc/articles/PMC9570780/ /pubmed/36233391 http://dx.doi.org/10.3390/jcm11195527 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gilardi, Emanuele
Pomero, Fulvio
Ravera, Enrico
Piccioni, Andrea
Santoro, Michele Cosimo
Bonadia, Nicola
Carnicelli, Annamaria
Di Maurizio, Luca
Sabia, Luca
Longhitano, Yaroslava
Saviano, Angela
Ojetti, Veronica
Savioli, Gabriele
Zanza, Christian
Franceschi, Francesco
Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care
title Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care
title_full Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care
title_fullStr Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care
title_full_unstemmed Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care
title_short Intravenous Magnesium Sulfate Reduces the Need for Antiarrhythmics during Acute-Onset Atrial Fibrillation in Emergency and Critical Care
title_sort intravenous magnesium sulfate reduces the need for antiarrhythmics during acute-onset atrial fibrillation in emergency and critical care
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570780/
https://www.ncbi.nlm.nih.gov/pubmed/36233391
http://dx.doi.org/10.3390/jcm11195527
work_keys_str_mv AT gilardiemanuele intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT pomerofulvio intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT raveraenrico intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT piccioniandrea intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT santoromichelecosimo intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT bonadianicola intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT carnicelliannamaria intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT dimaurizioluca intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT sabialuca intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT longhitanoyaroslava intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT savianoangela intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT ojettiveronica intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT savioligabriele intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT zanzachristian intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare
AT franceschifrancesco intravenousmagnesiumsulfatereducestheneedforantiarrhythmicsduringacuteonsetatrialfibrillationinemergencyandcriticalcare