TITLE:
Using Magnesium Sulfate to Prevent Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery: A Single Centre Experience in Bangladesh
AUTHORS:
Manoj Tiwari, Md. Abir Tazim Chowdhury, Hema Poudel, Munama Magdum, Md. Mostafizur Rahman, Vivek Kumar Jha, Md. Ahaduzzaman, Md. Abul Bashar Maruf
KEYWORDS:
Atrial Fibrillation (AF), Coronary Artery Bypass Grafting (CABG), Postopera-tive Atrial Fibrillation (POAF), Magnesium Sulfate, Bangladesh
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.9,
September
25,
2023
ABSTRACT: Background: Atrial fibrillation commonly occurs following cardiac surgery,
particularly after coronary artery bypass grafting. Magnesium, known for its
stabilizing effect on cell membranes, has shown promise in preventing
postoperative atrial fibrillation. This study aimed to assess the impact of
intravenous magnesium infusion in preventing atrial fibrillation after off-pump
coronary artery bypass grafting, where maintaining stable cell membranes is
crucial in averting this complication. Methods: A cross-sectional study
was conducted at the Department of Cardiac Surgery, Bangabandhu Sheikh Mujib
Medical University, from March 2020 to February 2022. Sixty-six patients who
underwent off-pump coronary artery bypass grafting were enrolled and divided into
two groups. Group A (n = 33) received intravenous magnesium sulfate (10
mmol/2.47gm) for three days after surgery, while Group B (n = 33) did not
receive magnesium sulfate. Postoperative atrial fibrillation occurrence in the
Intensive Care Unit (ICU) within three days after surgery was evaluated using
convenient sampling. Statistical analysis was performed with SPSS version 26.0,
utilizing independent Student’s t-test for continuous data and Chi-square and
Fisher’s exact test for categorical data. A p-value of ≤0.05 was considered
statistically significant. Results: No significant differences in age or
gender were observed between the two groups. Group B exhibited significantly
lower magnesium levels than Group A on the 0th, 1st, 2nd,
and 3rd days post-surgery. Additionally, Group B
experienced a higher incidence of postoperative atrial fibrillation, longer ICU
stays, and two mortalities. The study did not detect any adverse effects
associated with magnesium infusion. Conclusion: It has been demonstrated
that administering magnesium intravenously after off-pump coronary artery
bypass grafting can lower the chances of developing atrial fibrillation. This
demonstrates the potential advantages of
using magnesium as a preventative measure for postoperative atrial fibrillation
in such cases.