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Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis
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  1. S Miller1,
  2. E Crystal1,
  3. M Garfinkle1,
  4. C Lau1,
  5. I Lashevsky1,
  6. S J Connolly2
  1. 1Arrhythmia Services, Schulich Heart Centre, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Medicine, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to:
    Dr Eugene Crystal
    Electrophysiology Program, Schulich Heart Centre, Sunnybrook and Women’s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5; eugene.crystalsw.ca

Abstract

Objectives: To assess the efficacy of the administration of magnesium as a method for the prevention of postoperative atrial fibrillation (AF) and to evaluate its influence on hospital length of stay (LOS) and mortality.

Methods: Literature search and meta-analysis of the randomised control studies published since 1966.

Results: 20 randomised trials were identified, enrolling a total of 2490 patients. Study sample size varied between 20 and 400 patients. Magnesium administration decreased the proportion of patients developing postoperative AF from 28% in the control group to 18% in the treatment group (odds ratio 0.54, 95% confidence interval (CI) 0.38 to 0.75). Data on LOS were available from seven trials (1227 patients). Magnesium did not significantly affect LOS (weighted mean difference −0.07 days of stay, 95% CI −0.66 to 0.53). The overall mortality was low (0.7%) and was not affected by magnesium administration (odds ratio 1.22, 95% CI 0.39 to 3.77).

Conclusion: Magnesium administration is an effective prophylactic measure for the prevention of postoperative AF. It does not significantly alter LOS or in-hospital mortality.

  • AF, atrial fibrillation
  • CABG, coronary artery bypass graft
  • CENTRAL, Cochrane Central Register of Controlled Trials
  • CI, confidence interval
  • LOS, length of stay
  • OR, odds ratio
  • magnesium
  • atrial fibrillation
  • surgery
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