Use of magnesium sulphate in the prophylaxis of atrial fibrillation post cardiac surgery, is it effective?

Abstract EN

Objective : To assess the effectiveness of magnesium sulphate in the prophylaxis of postoperative atrial fibrillation in patients undergoing elective coronary aortic bypass grafting or valvular heart surgery in terms of reducing its incidence and decreasing the length of hospital stay.

Methods : This study which was conducted at Queen Alia Heart Institute from June 2009 to June 2010 on 308 patients who underwent elective coronary artery bypass grafting or valvular heart surgery.

Patients were divided into two equal groups, the magnesium-treated and control groups (154 each).

Then each group was subdivided into patients who underwent coronary artery bypass grafting alone (n = 102), and patients underwent valvular surgery with or without coronary artery bypass grafting (n = 52).

In the treatment group, patients were given 3.0gm of magnesium sulphate intra-operatively, and later on for the first 4 consequent post operative days.

Results : About 8.4% developed atrial fibrillation in the treatment group in contrast 23.3% in the control group (P < 0.001).

In the subdivided groups, those patients who underwent only coronary artery bypass grafting, 7.8% and 23.5% developed atrial fibrillation in the treatment and control group respectively.

In the group of patients who underwent valvular heart surgery with or without CABG, 5 patients (9.6%) developed atrial fibrillation in the treatment group compared to 15 patients (28.8%) in the control group.

Atrial fibrillation developed after 34 ± 10.52 hours in the treatment group in comparison to 38 ± 11.23 hours which is statistically non-significant.

The length of hospital stay was 6.01 ± 2.15 days in the treatment group while it was 5.95 ± 1.85 days in the control group which was also found to be statistically non-significant.

Conclusion : Use of magnesium sulphate, both intraoperativley and postoperatively proved to be safe and effective in reducing the incidence of post operative atrial fibrillation in patients undergoing elective coronary artery bypass grafting or valvular heart surgery, but with no obvious significant effect on hospital stay.