Atrial arrhythmia magnesium

Wu X, Wang C, Zhu J, Zhang C, Zhang Y, Gao Y. Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting. BMC Cardiovasc Disord 2013 3 5. 

Heavy drinking—and especially "binge" drinking—are associated with both atrial and ventricular arrhythmias. Patients undergoing alcohol withdrawal syndrome can develop severe arrhythmias that may reflect abnormalities of potassium or magnesium metabolism as well as enhanced release of catecholamines. Seizures, syncope, and sudden death during alcohol withdrawal may be due to these arrhythmias. 

Terfenadine is adsorbed by activated charcoal and charcoal may be considered for substantial recent ingestions. There is no antidote for terfenadine overdose. Terfenadine therapy should be discontinued and standard supportive therapies should be utilized as clinically necessary. Close electrocardiographic monitoring should be instituted for a minimum of 24 h. Torsades de pointes may be treated with electrical cardioversion if the patient is hemodynamically unstable. Otherwise, magnesium, isoproterenol, and/ or atrial overdrive pacing may be used to manage this arrhythmia. 

In addition to drugs in these classes, others may be used for certain arrhythmias. Digoxin may be used for treatment of atrial fibrillation, adrenaline for asystolic cardiac arrest, atropine for sinus bradycardia, methacholine (rarely) for supraventricular tachycardia, magnesium salts for ventricular arrhythmias, and calcium salts for ventricular arrhythmia due to hyperkalaemia. 

One of the more serious complications of magnesium deficiency is cardiac arrhythmias. Premature atrial complexes, atrial tachycardia and fibrillation, ventricular premature complexes, ventricular tachycardia, and ventricular fibrillation may be associated with magnesium deficiency. These effects maybe partly caused by the hypokalemia, renal wasting, and intracellular depletion of potassium caused by hypomagnesemia. 

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