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Magnesium in addition to sotalol does not influence the incidence of postoperative atrial tachyarrhythmias after coronary artery bypass surgery.

Abstract：

OBJECTIVE:Postoperative atrial tachyarrhythmias (POATs) after coronary artery bypass grafting (CABG) are reported in 11% to 40% of patients. Several etiologic factors are mentioned. Prophylactic intervention with sotalol is reported to reduce the incidence of POAT. The authors studied the effect of magnesium chloride (MgCl2) in addition to sotalol in the prevention of POAT. DESIGN:Prospective, randomized, double-blinded, placebo-controlled trial. SETTING:Single center. PARTICIPANTS AND INTERVENTIONS:After institutional approval and written informed consent, patients undergoing CABG with use of cardiopulmonary bypass were included in a prospective, randomized, placebo-controlled double-blind study. In 74 patients, intravenous MgCl2, 50 mmol/24 hours, was continuously administered after the induction of anesthesia during 36 hours; 73 patients received placebo. In both groups, sotalol orally was started 16 to 24 hours after CABG. The incidence and duration of in-hospital POAT were evaluated. MEASUREMENTS AND MAIN RESULTS:A total of 147 patients could be evaluated: in the magnesium-treated group (n = 74), 25 patients developed POAT (34%) and in the placebo group (n = 73) 19 patients (26%) (p = 0.36). There was no statistically significant difference in duration of POAT between the groups. In the magnesium-treated group, 9 patients experienced serious bradyarrhythmias (12%), and in the placebo group no serious bradyarrhythmias were observed (p = 0.003). There was no mortality in either group. CONCLUSIONS:These results show that MgCl(2), in addition to sotalol, is not more effective than sotalol alone in the prevention of tachyarrhythmias after CABG. The data showed that this combination may also induce serious bradyarrhythmias.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Geertman H,van der Starre PJ,Sie HT,Beukema WP,van Rooyen-Butijn M

doi

10.1053/j.jvca.2004.03.010

keywords:

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

309-12

issue

eissn

1053-0770

issn

1532-8422

pii

S1053077004000667

journal_volume

pub_type

临床试验,杂志文章,随机对照试验

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Magnesium in addition to sotalol does not influence the incidence of postoperative atrial tachyarrhythmias after coronary artery bypass surgery.