Original articleCardiovascularThree-Day Magnesium Administration Prevents Atrial Fibrillation After Coronary Artery Bypass Grafting
Section snippets
Study Population
A retrospective study was conducted reviewing all patients who had undergone isolated, initial CABG at Sakakibara Heart Institute, Tokyo, Japan, before and after the time point when the magnesium supplementation protocol was initiated (April 1, 2002). Exclusion criteria included history of AF or other supraventricular arrhythmias (including paroxysmal supraventricular arrhythmias), implanted permanent pacemaker, postoperative myocardial infarction, and severe hemodynamic disorder requiring
Results
The incidence of postoperative AF was 16% (16 patients) in the magnesium-treated group and 35% (35 patients) in the untreated group (p = 0.002). Regarding time of AF onset and duration of postoperative hospital stay, no statistically significant difference was found between the two groups (Table 2).
Mean serum magnesium concentration decreased to subnormal value (reference range, 1.8 to 2.6 mg/dL) immediately after surgery in both magnesium-treated and untreated groups (Fig 1). The two groups
Comment
The reported incidences of AF after CABG range from 10% to 50% 1, 5, 6. Despite recent improvements in perioperative management, its occurrence has not decreased during the years and is associated with significant morbidity. Given this consequence, a wide variety of prophylactic strategies have been evaluated, including perioperative magnesium administration; at present, the efficacy of this treatment is still controversial. In the 100 consecutive patients we reviewed who did not receive the
Acknowledgement
This study could not have been performed without the support and cooperation of the medical and nursing staff of the intensive care and cardiovascular surgical units of Sakakibara Heart Institute. Deep appreciation is extended to Ryo Hoshino, MD, Ikuko Shibazaki, MD, Keima Nagamachi, MD, Hiroki Hayashi, MD, Naoki Wada, MD, Tomoki Shimokawa, MD, and Takao Ida, MD, for their contributions and technical assistance in the preparation of the study. We also thank the cardiovascular staff of Chiba
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