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Deprecated: Implicit conversion from float 247.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Pacing+Clin+Electrophysiol 2007 ; 30 (11): 1331-5 Nephropedia Template TP
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Intravenous magnesium sulfate enhances the ability of intravenous ibutilide to successfully convert atrial fibrillation or flutter #MMPMID17976094
Tercius AJ; Kluger J; Coleman CI; White CM
Pacing Clin Electrophysiol 2007[Nov]; 30 (11): 1331-5 PMID17976094show ga
BACKGROUND: A previous randomized trial found that adjunctive use of intravenous magnesium (a total of 4 grams) can attenuate the corrected QT interval (QTc) prolongation associated with ibutilide, but its impact on ibutilide efficacy has not been elucidated. METHODS: This was a cohort evaluation of 229 consecutive patients who received ibutilide in the presence or absence of intravenous magnesium. Multivariate logistic regression analysis was used to determine the impact of magnesium on ibutilide efficacy as well as the impact of magnesium dosing intensity on ibutilide efficacy. RESULTS: The overall chemical conversion rate with ibutilide in the presence or absence of magnesium was 59.8%. The concurrent administration of magnesium (n = 141) was associated with a 78% increased odds of successful chemical conversion (adjusted odds ratio, AOR; 1.78 [95% confidence intervals,CI 1.02-3.09]) compared to those who did not receive magnesium (n = 88). Magnesium dosing intensity appeared to be an important determinant of ibutilide efficacy, with the 4 grams dose associated with a threefold increase in the odds of successful chemical conversion (AOR; 2.98 [95% CI 1.46-6.11). The 1 to 3 grams subgroup was associated with only a trend toward an improvement. There was only one case of Torsade de Pointes (TdP) which occurred in the no adjunctive magnesium group. CONCLUSIONS: Concurrent use of magnesium enhanced the ability of ibutilide to successfully convert atrial fibrillation (AF) or flutter (AFl). The 4 grams magnesium dose appeared to provide the greatest benefit.