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Intravenous magnesium is often used along with ibutilide during the treatment of atrial fibrillation and flutter to prevent torsades de pointes. Its effect on the efficacy of ibutilide in this setting is not well established.
We searched PubMed, Embase and Cochrane databases to identify studies that compared the efficacy of magnesium with ibutilide versus ibutilide alone in the treatment of atrial fibrillation and flutter using the key words “magnesium” “ibutilide” “atrial fibrillation” and “atrial flutter”. Two investigators independently reviewed the articles. Twelve studies were identified but after review, four studies were included in the final meta analysis.
A total of 1143 patients were included in the analysis. Compared to ibutilide alone, concomitant administration of intravenous magnesium with ibutilide significantly increases the efficacy of conversion to sinus rhythm (OR = 1.66, 95% CI 1.29-2.15, p<0.0001) with no significant heterogeneity among the studies included (12=0%). The incidence of ventricular arrhythmias was significantly reduced with magnesium (3.25% vs 6.27%, p=0.03). There were no significant side effects with magnesium use identified in these studies.
Intravenous magnesium safely and significantly enhances the efficacy of ibutilide in the conversion of atrial fibrillation and flutter.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias: AF/SVT V
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1189-33
- 2013 American College of Cardiology Foundation