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ED use of magnesium sulphate improved rate control in atrial fibrillation with rapid ventricular response

Clinical impact ratings IM/Ambulatory care Emergency medicine Cardiology

Key Words: atrial fibrillation • antiarrhythmia agents • magnesium sulphate

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial (RCT).

Allocation: {concealed^*}.

Blinding: blinded (patients, clinicians, {data collectors, outcome assessors, monitoring committee}, and data analysts).^*

Follow up period: up to 150 minutes.

Setting: 2 academic, tertiary referral EDs in South Australia.

Patients: 199 patients (approximately 52% women) >18 years of age who presented to the ED with AF and a ventricular response rate >120 beats/min. Exclusion criteria were haemodynamic instability, history of renal failure or atrioventricular node disease (except for patients with primary atrioventricular block or permanent pacemakers), or acute myocardial infarction with electrocardiographic criteria for thrombolysis.

Intervention: magnesium sulphate, 40 mEq (5 g, 20 mmol), in 100 ml 5% dextrose solution, with 20 mEq (2.5 g, 10 mmol) given intravenously over 20 minutes, followed by the remaining 20 mEq over the next 2 hours (n = 102); or an equivalent volume of 5% dextrose solution at the same infusion rates (placebo) . . . [Full text of this article]

Eddy S Lang, MDCM, CCFP(EM), CSPQ

SMBD Jewish General Hospital, McGill University
Montreal, Quebec, Canada