Effects of magnesium on atrial fibrillation after cardiac surgery: a meta-analysis

Abstract

Objectives: To assess the efficacy of the administration of magnesium as a method for the prevention of postoperative atrial fibrillation (AF) and to evaluate its influence on hospital length of stay (LOS) and mortality.

Methods: Literature search and meta-analysis of the randomised control studies published since 1966.

Results: 20 randomised trials were identified, enrolling a total of 2490 patients. Study sample size varied between 20 and 400 patients. Magnesium administration decreased the proportion of patients developing postoperative AF from 28% in the control group to 18% in the treatment group (odds ratio 0.54, 95% confidence interval (CI) 0.38 to 0.75). Data on LOS were available from seven trials (1227 patients). Magnesium did not significantly affect LOS (weighted mean difference -0.07 days of stay, 95% CI -0.66 to 0.53). The overall mortality was low (0.7%) and was not affected by magnesium administration (odds ratio 1.22, 95% CI 0.39 to 3.77).

Conclusion: Magnesium administration is an effective prophylactic measure for the prevention of postoperative AF. It does not significantly alter LOS or in-hospital mortality.

Figures

Figure 1

Incidence of postoperative atrial fibrillation. AF, atrial fibrillation developed postoperatively; CI, confidence interval; OR, odds ratio; total no. patients, total number of patients enrolled in the study.

Figure 2

Effects of magnesium on hospital length of stay (days). WMD, weighted mean difference.