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Intravenous Administration of Magnesium and Potassium Solution Lowers Energy Levels and Increases Success Rates Electrically Cardioverting Atrial Fibrillation
Author(s) -
SULTAN ARIAN,
STEVEN DANIEL,
ROSTOCK THOMAS,
HOFFMANN BORIS,
MÜLLERLEILE KAI,
SERVATIUS HELGE,
DREWITZ IMKE,
LÜKER JAKOB,
MEYER PHILIP,
SALUKHE TUSHAR,
WILLEMS STEPHAN
Publication year - 2012
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2011.02146.x
Subject(s) - medicine , atrial fibrillation , sinus rhythm , cardioversion , anesthesia , bradycardia , sinus bradycardia , cardiology , potassium , magnesium , heart rate , blood pressure , chemistry , materials science , organic chemistry , metallurgy
Intravenous Electrolytes Increase Success Rate of Cardioversion . Background: External biphasic electrical cardioversion (CV) is a standard treatment option for patients suffering from acute symptoms of atrial fibrillation (AF). Nevertheless, CV is not always successful, and thus strategies to increase the success rate are desirable. Objective: The purpose of this study was to evaluate the effect of intravenously administered K/Mg solution on the biphasic CV energy threshold and success rate to restore sinus rhythm (SR) in patients with AF. Methods: The study consisted of 170 patients with persistent AF. The patients were randomly assigned to undergo biphasic CV either with (n = 84) or without (n = 86) pretreatment with K/Mg solution. An energy step‐up protocol of 75, 100, and 150 W (J) was used. Results: Biphasic CV of AF was effective in 81 (96.4%) patients in the pretreatment and 74 (86.0%) patients in the control group (P = 0.005). The effective energy level required to achieve SR was significantly lower in the pretreated group (140.8 ± 26.9 J vs 182.5 ± 52.2 J, P = 0.02). No K/Mg‐solution‐associated side effects such as hypotension or bradycardia were observed. Conclusion: Administration of K/Mg solution positively influences the success rate of CV in patients with persistent AF. Furthermore, significantly less energy is required to successfully restore SR and therefore K/Mg pretreatment may facilitate SR restoration in patients undergoing CV for AF. (J Cardiovasc Electrophysiol, Vol. 23, pp. 54‐59, January 2012)