Special articleMagnesium prophylaxis for arrhythmias after cardiac surgery: A meta-analysis of randomized controlled trials
Section snippets
Literature search
We searched the literature for all reports of randomized controlled trials that tested the effects of prophylactic magnesium, compared with that of treatments without magnesium, on the development of arrhythmias after cardiac surgery. Trials were identified from MEDLINE (1966 through June 2003), EMBASE (1980 through June 2003), and the Cochrane Central Register of Controlled Trials (Issue 3, 2003). No language restrictions were applied. The initial search terms were magnesium, arrhythmia,
Results
Of the 28 trials identified, 11 failed to meet our inclusion criteria and were excluded. Three had no control group (18, 19, 20), four had no randomized design or the randomization process was unclear (21, 22, 23, 24), one had insufficient data (no dichotomous outcome) (25), one did not use magnesium as prophylaxis (26), one did not report details on supraventricular or ventricular arrhythmias (27), and one had nonspecific data for which we attempted to contact the authors but received no
Discussion
The incidence of supraventricular arrhythmias following coronary artery bypass is 11% to 40% (1), and the incidence is higher in patients who have valvular surgery alone or combined with coronary artery bypass (1, 4). Atrial fibrillation is the most common arrhythmia, with a prevalence of 17% to 33% in patients undergoing coronary artery bypass surgery (43). In our analysis, most patients underwent elective coronary artery bypass grafting alone. The incidence of supraventricular arrhythmias was
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