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Updated: Sep 26, 2025

Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation
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Sterile Pericarditis in Aachener Minipigs As a Model for Atrial Myopathy and Atrial Fibrillation

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Preoperative oral magnesium loading to prevent postoperative atrial fibrillation following coronary surgery: a

Joanna Tohme1, Ghassan Sleilaty2,3, Khalil Jabbour1

  • 1Department of Anesthesia and Critical Care, Hôtel-Dieu de France hospital, Université Saint-Joseph, Beirut, Lebanon.

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|April 22, 2022
PubMed

Insights

Preoperative magnesium loading significantly reduced the incidence of postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG) surgery. This intervention offers a promising strategy to prevent POAF after CABG.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Pharmacology

Background:

  • Postoperative atrial fibrillation (POAF) is a frequent complication following coronary artery bypass grafting (CABG).
  • Hypomagnesemia is commonly observed in patients post-CABG.
  • The efficacy of preoperative magnesium (Mg) loading in preventing POAF has not been previously investigated.

Purpose of the Study:

  • To assess the effect of preoperative magnesium loading on the incidence of POAF in patients undergoing CABG surgery.
  • To evaluate secondary outcomes including extubation time, transfusion rates, and length of stay in critical care and hospital.

Main Methods:

  • A single-center, double-blind, placebo-controlled, parallel-group randomized trial (1:1 ratio).
  • Participants received either oral magnesium (3.2g daily for 72h preoperatively and 1.6g on surgery day) or placebo.
  • Recruitment occurred from November 2018 to May 2019, with 200 participants completing the study.

Main Results:

  • The incidence of POAF was significantly lower in the magnesium group (10%) compared to the placebo group (22%) (RR=0.45, 95% CI: 0.23-0.91).
  • Hospital and critical care unit lengths of stay were similar between the two groups.
  • No adverse side effects were reported with magnesium administration.

Conclusions:

  • Preoperative oral magnesium loading for three days prior to CABG surgery effectively decreases the incidence of POAF.
  • Magnesium administration is a safe and potentially beneficial intervention for preventing POAF in CABG patients.
Abstract

Keywords:
Coronary artery bypass surgeryMagnesiumOralPostoperative atrial fibrillationPrevention

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