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Published on: September 15, 2023
Relationship between serum magnesium level and arrythmias following post-coronary artery bypass grafting
Mahdi Najafi1, Babak Haghighat, Hossein Ahmadi Tafti
1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. najafik@sina.tums.ac.ir
Insights
Routine magnesium administration did not significantly alter serum magnesium levels or reduce perioperative arrhythmias after coronary artery bypass graft surgery. However, maintaining normal magnesium levels remains important.
Area of Science:
- Cardiology
- Anesthesiology
- Critical Care Medicine
Background:
- Post-coronary artery bypass graft (CABG) surgery commonly involves atrial and ventricular arrhythmias.
- Cardiopulmonary bypass is known to decrease serum magnesium levels.
- The relationship between total blood magnesium and perioperative arrhythmias requires further investigation.
Purpose of the Study:
- To evaluate the association between total blood magnesium levels (TMG) and the incidence of perioperative arrhythmias in CABG patients.
- To assess the impact of routine magnesium supplementation on serum magnesium levels and arrhythmia occurrence.
Main Methods:
- Total blood magnesium (TMG) was measured in 170 CABG patients pre-anesthesia, upon ICU arrival, and post-operation.
- Patients were monitored for cardiac rhythm, serum creatinine, urine output, and diuretic use.
- Arrhythmia rates and types were recorded for 3 days post-surgery, along with supplemental magnesium (SMG) administration.
Main Results:
- Mean TMG levels remained within the normal range across all measurement points.
- 31% of patients developed post-operative arrhythmias, including Atrial Fibrillation (7.1%), Non-AF Supraventricular arrhythmia (14.7%), and Ventricular arrhythmia (16.5%).
- No significant difference in TMG was observed between patients with and without arrhythmias, despite slightly higher levels in the arrhythmic group.
Conclusions:
- Routine magnesium administration did not significantly impact serum magnesium levels or reduce the incidence of perioperative arrhythmias.
- While routine supplementation may not prevent arrhythmias, maintaining normal magnesium levels is likely crucial.
- Further research may be needed to optimize magnesium management strategies in cardiac surgery patients.
Introduction:
Atrial and ventricular arrhythmias are among the most common complications after coronary artery bypass graft (CABG) surgery. It is known that cardiopulmonary bypass reduces serum magnesium level. In this study, we evaluated the relationship between total blood magnesium level (TMG) and the incidence of perioperative arrhythmias.
Methods:
TMG was measured in patients who were scheduled for CABG on three occasions: just before anesthesia, on intensive care unit (ICU) arrival and on the first morning after operation. Patients were evaluated for primary cardiac rhythm, serum creatinine, urine output in operating room and diuretic therapy. Supplemental magnesium (SMG) was also recorded in operating room and ICU. Patients were then evaluated for the rate and kind of arrhythmia occurring during the next 3 days.
Results:
Mean TMG level in 170 cases was 2.2 (0.5), 2.6 (0.6) and 2.4 (0.6) mg/dl on three occasions respectively. 53 patients developed post-operative arrhythmia (31%) [Atrial Fibrillation (AF) (7.1%), Non-AF Supraventricular arrhythmia (14.7%) and Ventricular arrhythmia (16.5%)]. Although there was a significant difference between TMG on three occasions (P <0.001), all values were within normal range. Although TMG was higher in arrhythmic patients compared to non- arrhythmics (2.26 vs. 2.14), both values were in normal range and there was no significant difference between two groups.
Discussion:
This study shows that routine magnesium administration has no significant effect on serum magnesium level. We conclude that though routine regimen of magnesium administration has no effect on incidence of perioperative arrhythmia, it is probably necessary for maintaining normal magnesium level.
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