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[Significance of magnesium in cardiac arrhythmias]
H G Stühlinger1, K Kiss, R Smetana
1Universitätsklinik für Nofallmedizin, Wien. H.Georg.Stuehlinger@akh-wien.ac.at
Insights
Magnesium plays a crucial role in managing cardiac arrhythmias, including Torsade de pointes and digitalis toxicity. Both intravenous and oral magnesium effectively treat various ventricular and atrial arrhythmias, improving patient outcomes.
Area of Science:
- Cardiology
- Electrophysiology
- Pharmacology
Background:
- Cardiac arrhythmias represent a significant clinical challenge.
- Magnesium's role in cardiac electrophysiology is well-established.
- Various arrhythmias necessitate effective therapeutic interventions.
Purpose of the Study:
- To review the importance of magnesium in cardiac arrhythmias.
- To outline the indications for intravenous (IV) magnesium therapy.
- To discuss the efficacy of oral magnesium for specific arrhythmias.
Main Methods:
- Literature review of studies on magnesium and cardiac arrhythmias.
- Analysis of clinical evidence for IV and oral magnesium applications.
- Synthesis of data regarding magnesium's electrophysiological effects.
Main Results:
- IV magnesium is indicated for Torsade de pointes, digitalis toxicity, and multifocal atrial tachycardias.
- Magnesium effectively treats ventricular arrhythmias from neuroleptic/tricyclic antidepressant overdose.
- Monomorphic ventricular tachycardias and refractory arrhythmias respond to IV magnesium.
- Perioperative magnesium reduces atrial and ventricular arrhythmic events.
- Oral magnesium reduces symptomatic extrasystoles.
Conclusions:
- Magnesium is a vital therapeutic agent for a spectrum of cardiac arrhythmias.
- Both IV and oral magnesium formulations offer significant clinical benefits.
- Magnesium therapy should be considered in managing various tachyarrhythmias and extrasystoles.
Abstract:
Magnesium is of great importance in cardiac arrhythmias. It increases the ventricular threshold for fibrillation. Sinus node refractoriness and conduction in the AV node are both prolonged. Main indications for intravenous application of magnesium are Torsade de pointes tachycardias, digitalis toxicity induced tachyarrhythmias and multifocal atrial tachycardias. Additionally, patients with ventricular arrhythmias due to overdoses of neuroleptics or tricyclic antidepressants may profit from i.v. magnesium. Monomorphic ventricular tachycardias and ventricular arrhythmias refractory to class III antiarrhythmics have been shown to respond to i.v. magnesium. Recent publications have documented that perioperative use of magnesium can reduce the incidence of arrhythmic events on the atrial and ventricular level. Oral magnesium has been used for many years in patients with symptomatic extrasystoles. Studies show that the incidence of extrasystoles as well as patients' symptoms are reduced during oral magnesium therapy.