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Updated: Jan 31, 2026
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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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Association Between Protocolized Magnesium Supplementation and Atrial Fibrillation or Flutter in Critically Ill
Christopher J Yarnell1,2,3,4, Federico Angriman3,4,5, Eliot Beaubien6,7
1Department of Critical Care Medicine, Scarborough Health Network, Toronto, ON, Canada.
Critical Care Medicine
|January 30, 2026
Summary
Protocolized magnesium supplementation in ICUs may reduce the incidence of atrial fibrillation and flutter. This practice, initiated when serum magnesium levels are below 0.95 mmol/L, shows potential benefits for critically ill patients.
Area of Science:
- Critical Care Medicine
- Cardiology
- Clinical Pharmacology
Background:
- Intensive care units (ICUs) frequently use protocolized magnesium supplementation.
- The clinical impact of routine magnesium supplementation in ICUs remains largely uncharacterized.
Purpose of the Study:
- To investigate the clinical effect of protocolized magnesium supplementation in critically ill patients.
- To determine if magnesium supplementation impacts the incidence of atrial fibrillation or flutter within 24 hours.
Main Methods:
- A pseudo-randomized retrospective study was conducted across five Ontario hospitals.
- Patients with serum magnesium levels between 0.92-0.99 mmol/L were analyzed.
- The primary outcome was the occurrence of atrial fibrillation or flutter within 24 hours of ICU admission.
Main Results:
- The study included 4198 patients; 51% received magnesium supplementation.
- Atrial fibrillation or flutter occurred in 16.6% of the supplementation group versus 18.3% in the no-supplementation group.
- A 1.6% absolute risk reduction in atrial fibrillation/flutter was observed with supplementation (probability of reduction, 0.91).
Conclusions:
- Protocolized magnesium supplementation at a threshold of 0.95 mmol/L may decrease the 24-hour incidence of atrial fibrillation and flutter.
- This practice shows potential for reducing adverse cardiac events in critically ill populations.
- Further prospective studies may be warranted to confirm these findings.
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