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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

My Heart is Racing! Select Cardiac Arrhythmias and Practice Updates

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domingo, 30 de octubre de 2016

Mg for AF

ALiEM
ALiEM - October 26th, 2016 - By: Bryan D. Hayes
"We love magnesium in the Emergency Department. It’s been said that magnesium is second-line for everything (kind of like doxycycline). But what about rate/rhythm control in atrial fibrillation (AF)? The 2014 AHA/ACC/HRS guideline for the management of patients with AF doesn’t mention magnesium at all.1 Dr. Josh Farkas wrote about magnesium infusions for atrial fibrillation and torsade last year. His post looked at its use for cardioversion, rhythm-control, and rate-control in critically-ill patients. Our post will focus specifically on the IV magnesium data for rate-control in ED-related settings...
BOTTOM LINE
Magnesium seems to be safe and moderately effective for reducing heart rate in rapid AF. Even in the studies where magnesium was less effective than an active comparator, it still demonstrated some reduction in HR. Therefore, consider administering 2 gm of IV magnesium as an adjunctive therapy while you are choosing between a calcium channel blocker or beta blocker as the primary agent."