학술논문

Efficacy of intravenous magnesium for the management of non‐post operative atrial fibrillation with rapid ventricular response: A systematic review and meta‐analysis.
Document Type
Article
Source
Journal of Cardiovascular Electrophysiology. May2023, Vol. 34 Issue 5, p1286-1295. 10p. 1 Diagram, 3 Charts, 5 Graphs.
Subject
*THERAPEUTIC use of magnesium
*DRUG efficacy
*ONLINE information services
*INTRAVENOUS therapy
*META-analysis
*MEDICAL information storage & retrieval systems
*CONFIDENCE intervals
*SYSTEMATIC reviews
*ATRIAL fibrillation
*HEALTH outcome assessment
*MAGNESIUM
*QUALITY assurance
*DESCRIPTIVE statistics
*MEDLINE
*DATA analysis software
*ODDS ratio
Language
ISSN
1045-3873
Abstract
Background: Intravenous magnesium (IV Mg), a commonly utilized therapeutic agent in the management of atrial fibrillation (AF) with rapid ventricular response, is thought to exert its influence via its effect on cellular automaticity and prolongation of atrial and atrioventricular nodal refractoriness thus reducing ventricular rate. We sought to undertake a systematic review and meta‐analysis of the effectiveness of IV Mg versus placebo in addition to standard pharmacotherapy in the rate and rhythm control of AF in the nonpostoperative patient cohort given that randomized control trials (RCTs) have shown conflicting results. Methods: Randomized controlled trials comparing IV Mg versus placebo in addition to standard of care were identified via electronic database searches. Nine RCTs were returned with a total of 1048 patients. Primary efficacy endpoints were study‐defined rate control and rhythm control/reversion to sinus rhythm. The secondary endpoint was patient experienced side effects. Results: Our analysis found IV Mg in addition to standard care was successful in achieving rate control (odd ratio [OR] 1.87, 95% confidence interval [CI] 1.13−3.11, p =.02) and rhythm control (OR 1.45, 95% CI 1.04−2.03, p =.03). Although not well reported among studies, there was no significant difference between groups regarding the likelihood of experiencing side effects. Conclusions: IV Mg, in addition to standard‐of‐care pharmacotherapy, increases the rates of successful rate and rhythm control in nonpostoperative patients with AF with rapid ventricular response and is well tolerated. [ABSTRACT FROM AUTHOR]