The Effect of Perioperative Magnesium Sulphate on the Incidence of Atrial Fibrillation in Patients Undergoing Coronary Artery Surgery: A Double-Blinded Randomized Study

Background and aims: The study aimed was to assess the effect of magnesium on the incidence of atrial fibrillation undergoing coronary artery surgery.

Materials and Methods: A double-blinded randomized study included 276 patients classified into two groups (each=138): Group M–the patients received magnesium sulphate infusion (15 mg/kg/h). The infusion was started 20 min before induction, during surgery and the first postoperative 24 hours. Group C–the patients received an equal amount of normal saline. The variables included incidence of atrial fibrillation, amiodarone level of magnesium, potassium, troponin I and creatinine kinase-MB, ECG changes.

Results: The incidence of atrial fibrillation was 17(12.31%) patients in group M compared to 38(27.53%) patients in group C(P=0.002). The highest incidence was through the second day and it was 8(12.31%) patients in group M compared to 19(12.31%) patients in group C(P=0.042). The requirement for amiodarone was 17(12.31%) patients in group M compared to 38(27.53%) patients in group C(P=0.002). The blood level of magnesium and potassium was significantly higher in group M compared to group C(P<0.05). The troponin I level, CK-MB and ECG changes were lower in group M than group C(P<0.05). The magnesium sulphate decreases the incidence of atrial fibrillation in patients with ischemic heart diseases undergoing CABG. It decreases the requirement for amiodarone, incidence of perioperative myocardial infarction, the requirement of pharmacological and mechanical support.

Keywords: Magnesium Sulfate, Coronary Artery Bypass Grafting, Atrial Fibrillation, Amiodarone, Troponin I, Creatinine Kinase-Mb Isoenzyme.