Document Detail


Magnesium sulfate versus placebo for paroxysmal atrial fibrillation: a randomized clinical trial.
MedLine Citation:
PMID:  19207134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The objective was to investigate the efficacy of magnesium sulfate (MgSO4) in decreasing the ventricular rate in emergency department (ED) patients presenting with new-onset, rapid atrial fibrillation (AF). METHODS: A double-blinded, placebo-controlled randomized clinical trial was conducted in an adult university hospital. Patients aged > or =18 years with AF onset of less than 48 hours and a sustained ventricular rate of >100 beats/min were randomized to either intravenous (IV) MgSO4 10 mmol or normal saline (NSal). Rhythm and instantaneous heart rate as measured by the monitor were recorded at baseline and every 15 minutes for 2 hours after starting the trial drug. Heart rate and rhythm were compared at 2 hours. A multilevel modeling analysis was performed to adjust for differences in baseline heart rate and any additional treatment and to examine changes in heart rate over time. RESULTS: Twenty-four patients were randomized to MgSO4 and 24 to NSal. Baseline heart rate was lower in the MgSO4 group (mean +/- standard deviation [+/-SD] = 125 +/- 24 vs. 140 +/- 21 beats/min]. One and 3 patients in the MgSO4 and NSal groups, respectively, were given another antiarrhythmic or were electrically cardioverted within 2 hours after starting the trial drug. Heart rate (mean +/- SD) at 2 hours in both MgSO4 (116 +/- 30 beats/min) and NSal groups (114 +/- 31 beats/min) decreased below their respective baseline levels. However, the rate of heart rate decrease across time did not differ between groups (p = 0.124). The proportion of patients who converted to sinus rhythm 2 hours post-trial drug did not differ (MgSO4 8.7% vs. NSal 25.0%, p = 0.25). CONCLUSIONS: This study was unable to demonstrate a difference between IV MgSO4 10 mmol and saline placebo for reducing heart rate or conversion to sinus rhythm at 2 hours posttreatment in ED patients with AF of less than 48 hours duration.
Authors:
Kevin Chu; Rhona Evans; Gregory Emerson; Jaimi Greenslade; Anthony Brown
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-02-10
Journal Detail:
Title:  Academic emergency medicine : official journal of the Society for Academic Emergency Medicine     Volume:  16     ISSN:  1553-2712     ISO Abbreviation:  Acad Emerg Med     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-05-21     Completed Date:  2009-10-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9418450     Medline TA:  Acad Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  295-300     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. uqkchu@uq.edu.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Arrhythmia Agents / pharmacology*
Atrial Fibrillation / drug therapy*
Double-Blind Method
Emergency Service, Hospital
Female
Heart Rate / drug effects*
Hospitals, University
Humans
Linear Models
Magnesium Sulfate / pharmacology*
Male
Middle Aged
Placebos
Queensland
Sodium Chloride
Time Factors
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Placebos; 7487-88-9/Magnesium Sulfate; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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