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Intravenous Magnesium for Cardiac Arrhythmias in Humans: A Role?

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Magnesium in Human Health and Disease

Part of the book series: Nutrition and Health ((NH))

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Abstract

Magnesium is an important intracellular ion and a cofactor for many enzymes involved in cell function of many body systems, including cardiovascular, metabolic, and nervous system. Magnesium has a wide range of physiological effects on the heart and circulatory system including calcium antagonism at both L- and T-type calcium channels, endothelial cell function and secretion, and regulation of energy transfer, and in pharmacological doses, magnesium decreases outward potassium current intensity resulting in membrane stabilization and acts as an indirect antagonist of digitalis at the sarcolemma Na-K-ATPase pump [1–3].

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References

  1. Wu JY, Lipsius SL. Effects of extracellular Mg2+ on T- and L-type Ca2+ currents in single atrial myocytes. Am J Physiol. 1990;259:H1842–50.

    PubMed  CAS  Google Scholar 

  2. Fawcett WJ, Haxby EJ, Male DA. Magnesium: physiology and pharmacology. Br J Anaesth. 1999;83:302–20.

    Article  PubMed  CAS  Google Scholar 

  3. Ingemansson MP, Smideberg B, Olsson SB. Intravenous MgSO4 alone and in combination with glucose, insulin and potassium (GIK) prolong the atrial cycle length in chronic atrial fibrillation. Europace. 2000;2:106–14.

    Article  PubMed  CAS  Google Scholar 

  4. Iseri LT, Allen BJ, Ginkel ML, Brodsky MA. Ionic biology and ionic medicine in cardiac arrhythmias with particular reference to magnesium. Am Heart J. 1992;123:1404–9.

    Article  PubMed  CAS  Google Scholar 

  5. DiCarlo Jr LA, Morady F, de Buitleir M, Krol RB, Schurig L, Annesley TM. Effects of magnesium sulfate on cardiac conduction and refractoriness in humans. J Am Coll Cardiol. 1986;7:1356–62.

    Article  PubMed  Google Scholar 

  6. Rasmussen HS, Larsen OG, Meier K, Larsen J. Hemodynamic effects of intravenously administered magnesium on patients with ischemic heart disease. Clin Cardiol. 1988;11:824–8.

    Article  PubMed  CAS  Google Scholar 

  7. Christiansen EH, Frost L, Andreasen F, Mortensen P, Thomsen PE, Pedersen AK. Dose-related cardiac electrophysiological effects of intravenous magnesium. A double-blind placebo-controlled dose–response study in patients with paroxysmal supraventricular tachycardia. Europace. 2000;2:320–6.

    Article  PubMed  CAS  Google Scholar 

  8. Viskin S, Belhassen B, Sheps D, Laniado S. Clinical and electrophysiologic effects of magnesium sulfate on paroxysmal supraventricular tachycardia and comparison with adenosine triphosphate. Am J Cardiol. 1992;70:879–85.

    Article  PubMed  CAS  Google Scholar 

  9. Sideris AM, Galiatsu E, Filippatos GS, Kappos K, Anthopoulos LP. Effects of magnesium and potassium on Wolff-Parkinson-White syndrome. J Electrocardiol. 1996;29:11–5.

    Article  PubMed  CAS  Google Scholar 

  10. Stiles MK, Sanders P, Disney P, Brooks A, John B, Lau DH, et al. Differential effects of intravenous magnesium on atrioventricular node conduction in supraventricular tachycardia. Am J Cardiol. 2007;100:1249–53.

    Article  PubMed  CAS  Google Scholar 

  11. Satoh Y, Sugiyama A, Tamura K, Hashimoto K. Effect of magnesium sulfate on the haloperidol-induced QT prolongation assessed in the canine in vivo model under the monitoring of monophasic action potential. Jpn Circ J. 2000;64:445–51.

    Article  PubMed  CAS  Google Scholar 

  12. Chinushi M, Sugiura H, Komura S, Hirono T, Izumi D, Tagawa M, et al. Effects of intravenous magnesium in a prolonged QT interval model of polymorphic ventricular tachycardia focus on transmural ventricular repolarization. Pacing Clin Electrophysiol. 2005;28:844–50.

    Article  PubMed  Google Scholar 

  13. Ince C, Schulman SP, Quigley JF, Berger RD, Kolasa M, Ferguson R, et al. Usefulness of magnesium sulfate in stabilizing cardiac repolarization in heart failure secondary to ischemic cardiomyopathy. Am J Cardiol. 2001;88:224–9.

    Article  PubMed  CAS  Google Scholar 

  14. Haigney MC, Berger R, Schulman S, Gerstenblith G, Tunin C, Silver B, et al. Tissue magnesium levels and the arrhythmic substrate in humans. J Cardiovasc Electrophysiol. 1997;8:980–6.

    Article  PubMed  CAS  Google Scholar 

  15. Chinushi M, Izumi D, Komura S, Ahara S, Satoh A, Furushima H, et al. Role of autonomic nervous activity in the antiarrhythmic effects of magnesium sulfate in a canine model of polymorphic ventricular tachyarrhythmia associated with prolonged QT interval. J Cardiovasc Pharmacol. 2006;48:121–7.

    Article  PubMed  CAS  Google Scholar 

  16. Farouque HM, Sanders P, Young GD. Intravenous magnesium sulfate for acute termination of sustained monomorphic ventricular tachycardia associated with coronary artery disease. Am J Cardiol. 2000;86:1270–2.

    Article  PubMed  CAS  Google Scholar 

  17. Crippa G, Sverzellati E, Giorgi-Pierfranceschi M, Carrara GC. Magnesium and cardiovascular drugs: interactions and therapeutic role. Ann Ital Med Int. 1999;14:40–5.

    PubMed  CAS  Google Scholar 

  18. Miller S, Crystal E, Garfinkle M, Lau C, Lashevsky I, Connolly SJ. Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis. Heart. 2005;91:618–23.

    Article  PubMed  CAS  Google Scholar 

  19. Saran T, Perkins GD, Javed MA, Annam V, Leong L, Gao F, et al. Does the prophylactic administration of magnesium sulphate to patients undergoing thoracotomy prevent postoperative supraventricular arrhythmias? A randomized controlled trial. Br J Anaesth. 2011;106:785–91.

    Article  PubMed  CAS  Google Scholar 

  20. Ho KM, Sheridan DJ, Paterson T. Use of intravenous magnesium to treat acute onset atrial fibrillation: a meta-analysis. Heart. 2007;93:1433–40.

    Article  PubMed  Google Scholar 

  21. Merrill JJ, DeWeese G, Wharton JM. Magnesium reversal of digoxin-facilitated ventricular rate during atrial fibrillation in the Wolff-Parkinson-White syndrome. Am J Med. 1994;97:25–8.

    Article  PubMed  CAS  Google Scholar 

  22. Kalus JS, Spencer AP, Tsikouris JP, Chung JO, Kenyon KW, Ziska M, et al. Impact of prophylactic i.v. magnesium on the efficacy of ibutilide for conversion of atrial fibrillation or flutter. Am J Health Syst Pharm. 2003;60:2308–12.

    PubMed  CAS  Google Scholar 

  23. Tercius AJ, Kluger J, Coleman CI, White CM. Intravenous magnesium sulfate enhances the ability of intravenous ibutilide to successfully convert atrial fibrillation or flutter. Pacing Clin Electrophysiol. 2007;30:1331–5.

    Article  PubMed  Google Scholar 

  24. Kinlay S, Buckley NA. Magnesium sulfate in the treatment of ventricular arrhythmias due to digoxin toxicity. J Toxicol Clin Toxicol. 1995;33:55–9.

    Article  PubMed  CAS  Google Scholar 

  25. McCord JK, Borzak S, Davis T, Gheorghiade M. Usefulness of intravenous magnesium for multifocal atrial tachycardia in patients with chronic obstructive pulmonary disease. Am J Cardiol. 1998;81:91–3.

    Article  PubMed  CAS  Google Scholar 

  26. Gupta A, Lawrence AT, Krishnan K, Kavinsky CJ, Trohman RG. Current concepts in the mechanisms and management of drug-induced QT prolongation and torsade de pointes. Am Heart J. 2007;153:891–9.

    Article  PubMed  Google Scholar 

  27. Winters SL, Sachs RG, Curwin JH. Nonsustained polymorphous ventricular tachycardia during amiodarone therapy for atrial fibrillation complicating cardiomyopathy. Management with intravenous magnesium sulfate. Chest. 1997;111:1454–7.

    Article  PubMed  CAS  Google Scholar 

  28. Sarisoy O, Babaoglu K, Tugay S, Barn E, Gokalp AS. Efficacy of magnesium sulfate for treatment of ventricular tachycardia in amitriptyline intoxication. Pediatr Emerg Care. 2007;23:646–8.

    Article  PubMed  Google Scholar 

  29. Knudsen K, Abrahamsson J. Magnesium sulphate in the treatment of ventricular fibrillation in amitriptyline poisoning. Eur Heart J. 1997;18:881–2.

    Article  PubMed  CAS  Google Scholar 

  30. Meikle A, Milne B. Management of prolonged QT interval during a massive transfusion: calcium, magnesium or both? Can J Anaesth. 2000;47:792–5.

    Article  PubMed  CAS  Google Scholar 

  31. van der Heide K, de Haes A, Wietasch GJ, Wiesfeld AC, Hendriks HG. Torsades de pointes during laparoscopic adrenalectomy of a pheochromocytoma: a case report. J Med Case Reports. 2011;5:368.

    Article  Google Scholar 

  32. Thwaites CL, Yen LM, Loan HT, Thuy TT, Thwaites GE, Stepniewska K, et al. Magnesium sulphate for treatment of severe tetanus: a randomised controlled trial. Lancet. 2006;368:1436–43.

    Article  PubMed  CAS  Google Scholar 

  33. LeDuc TJ, Carr JD. Magnesium sulfate for conversion of supraventricular tachycardia refractory to intravenous adenosine. Ann Emerg Med. 1996;27:375–8.

    Article  PubMed  CAS  Google Scholar 

  34. Allegra J, Lavery R, Cody R, Birnbaum G, Brennan J, Hartman A, et al. Magnesium sulfate in the treatment of refractory ventricular fibrillation in the prehospital setting. Resuscitation. 2001;49:245–9.

    Article  PubMed  CAS  Google Scholar 

  35. Hassan TB, Jagger C, Barnett DB. A randomised trial to investigate the efficacy of magnesium sulphate for refractory ventricular fibrillation. Emerg Med J. 2002;19:57–62.

    Article  PubMed  CAS  Google Scholar 

  36. Ulger Z, Ariogul S, Cankurtaran M, Halil M, Yavuz BB, Orhan B, et al. Intra-erythrocyte magnesium levels and their clinical implications in geriatric outpatients. J Nutr Health Aging. 2010;14:810–4.

    Article  PubMed  CAS  Google Scholar 

  37. Elin RJ. Assessment of magnesium status for diagnosis and therapy. Magnes Res. 2010;23:S194–8.

    PubMed  Google Scholar 

  38. Ralston MA, Murnane MR, Kelley RE, Altschuld RA, Unverferth DV, Leier CV. Magnesium content of serum, circulating mononuclear cells, skeletal muscle, and myocardium in congestive heart failure. Circulation. 1989;80:573–80.

    Article  PubMed  CAS  Google Scholar 

  39. Cook RC, Humphries KH, Gin K, Janusz MT, Slavik RS, Bernstein V, et al. Prophylactic intravenous magnesium sulphate in addition to oral {beta}-blockade does not prevent atrial arrhythmias after coronary artery or valvular heart surgery: a randomized, controlled trial. Circulation. 2009;120(11 Suppl):S163–9.

    Article  PubMed  CAS  Google Scholar 

  40. Kiziltepe U, Eyileten ZB, Sirlak M, Tasoz R, Aral A, Eren NT, et al. Antiarrhythmic effect of magnesium sulfate after open heart surgery: effect of blood levels. Int J Cardiol. 2003;89:153–8.

    Article  PubMed  Google Scholar 

  41. Cybulski J, Budaj A, Danielewicz H, Maciejewicz J, Ceremuzyński L. A new-onset atrial fibrillation: the incidence of potassium and magnesium deficiency. The efficacy of intravenous potassium/magnesium supplementation in cardioversion to sinus rhythm. Kardiol Pol. 2004;60:578–81.

    PubMed  Google Scholar 

  42. Ho KM. Intravenous magnesium for cardiac arrhythmias: jack of all trades. Magnes Res. 2008;21:65–8.

    PubMed  CAS  Google Scholar 

  43. Lowe SA, Brown MA, Dekker GA, Gatt S, McLintock CK, McMahon LP, et al. Society of obstetric medicine of Australia and New Zealand. Guidelines for the management of hypertensive disorders of pregnancy 2008. Aust N Z J Obstet Gynaecol. 2009;49:242–6.

    Article  PubMed  Google Scholar 

  44. Ho KM. Atrial tachyarrhythmia after cardiac surgery: role of magnesium infusion. Intensive Care Med. 1999;25:243.

    Article  PubMed  CAS  Google Scholar 

  45. Ho KM, Lewis JP. Prevention of atrial fibrillation in cardiac surgery: time to consider a multimodality pharmacological approach. Cardiovasc Ther. 2010;28:59–65.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Intensive Care Medicine, Royal Perth Hospital, Perth, Australia

    Kwok M. Ho MPH, Ph.D., FRCP, FANZCA, FCICM

  2. School of Population Health, University of Western Australia, Perth, Australia

    Kwok M. Ho MPH, Ph.D., FRCP, FANZCA, FCICM

Authors
  1. Kwok M. Ho MPH, Ph.D., FRCP, FANZCA, FCICM
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Corresponding author

Correspondence to Kwok M. Ho MPH, Ph.D., FRCP, FANZCA, FCICM .

Editor information

Editors and Affiliations

  1. Arizona Health Science Center, Mel and Enid Zuckerman, University of Arizona, 1295 N. Martin, Tucson, 85724-5155, Arizona, USA

    Ronald Ross Watson

  2. Dept. Nutrition & Dietetics, King's College, Stamford St. 150, London, SE1 9NH, United Kingdom

    Victor R. Preedy

  3. Division of Health Promotion Sciences, Mel and Enid Zuckerman, University of Arizona, 1295 N. Martin Avenue, Tucson, 85724, Arizona, USA

    Sherma Zibadi

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Ho, K.M. (2013). Intravenous Magnesium for Cardiac Arrhythmias in Humans: A Role?. In: Watson, R., Preedy, V., Zibadi, S. (eds) Magnesium in Human Health and Disease. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-044-1_15

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  • DOI: https://doi.org/10.1007/978-1-62703-044-1_15

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-043-4

  • Online ISBN: 978-1-62703-044-1

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