Magnesium supplementation in the prevention of arrhythmias in pediatric patients undergoing surgery for congenital heart defects

B. Hugh Dorman, Robert M. Sade, Jeffrey S. Burnette, Henry B Wiles, Mark L. Pinosky, Scott T. Reeves, Brian R. Bond, Francis G. Spinale

Research output: Contribution to journalArticle

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Abstract

Background: The efficacy of magnesium in the prevention of arrhythmias in pediatric patients after heart surgery remains unknown. Therefore we prospectively examined the effect of magnesium treatment on the incidence of postoperative arrhythmias in pediatric patients undergoing surgical repair of congenital heart defects. Methods and Results: Twenty-eight pediatric patients undergoing heart surgery with cardiopulmonary bypass were prospectively, randomly assigned in a double-blind fashion to receive intravenous magnesium (magnesium group, n = 13; 30 mg/kg) or saline (placebo group, n = 15) immediately after cessation of cardiopulmonary bypass. Magnesium, potassium, and calcium levels were measured at defined intervals during surgery and 24 hours after surgery. Continuous electrocardiographic documentation by Halter monitor was performed for 24 hours after surgery. Magnesium levels were significantly decreased below the normal reference range for patients in the placebo group compared with the magnesium group on arrival in the intensive care unit and for 20 hours after surgery. Magnesium levels remained in the normal range for patients in the magnesium group after magnesium supplementation. In 4 patients in the placebo group (27%), junctional ectopic tachycardia developed within the initial 20 hours in the intensive care unit. No junctional ectopic tachycardia was observed in the magnesium group (P = .026). Conclusions: Although this study was originally targeted to include 100 patients, the protocol was terminated because of the unacceptable incidence of hemodynamically significant junctional ectopic tachycardia that was present in the placebo group. Thus low magnesium levels in pediatric patients undergoing heart surgery are associated with an increased incidence of junctional ectopic tachycardia in the immediate postoperative period.

Original languageEnglish (US)
Pages (from-to)522-528
Number of pages7
JournalAmerican Heart Journal
Volume139
Issue number3
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

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Congenital Heart Defects
Magnesium
Cardiac Arrhythmias
Pediatrics
Ectopic Junctional Tachycardia
Placebos
Thoracic Surgery
Reference Values
Cardiopulmonary Bypass
Intensive Care Units
Incidence
Postoperative Period
Documentation
Potassium

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Magnesium supplementation in the prevention of arrhythmias in pediatric patients undergoing surgery for congenital heart defects. / Dorman, B. Hugh; Sade, Robert M.; Burnette, Jeffrey S.; Wiles, Henry B; Pinosky, Mark L.; Reeves, Scott T.; Bond, Brian R.; Spinale, Francis G.

In: American Heart Journal, Vol. 139, No. 3, 01.01.2000, p. 522-528.

Research output: Contribution to journalArticle

Dorman, B. Hugh ; Sade, Robert M. ; Burnette, Jeffrey S. ; Wiles, Henry B ; Pinosky, Mark L. ; Reeves, Scott T. ; Bond, Brian R. ; Spinale, Francis G. / Magnesium supplementation in the prevention of arrhythmias in pediatric patients undergoing surgery for congenital heart defects. In: American Heart Journal. 2000 ; Vol. 139, No. 3. pp. 522-528.
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