Perticone F, Ceravolo R, De Novara G, Torchia L, Cloro C
Department of Clinical and Experimental Medicine, School of Medicine, University of Reggio Calabria, Italy.
Magnes Res. 1992 Dec;5(4):265-72.
Antiarrhythmic magnesium (Mg) therapy was evaluated in 20 normomagnesaemic patients affected by ischaemic dilated cardiomyopathy (ID) and severe ventricular arrhythmias, and in 10 patients with torsade de pointes (TdP) occurring in the setting of acquired QT interval prolongation. In the group with IDC, magnesium sulphate was given as slow infusions (50 mg/min over 60 min) twice a day for 7 d. This was antiarrhythmic in all of the patients: ventricular premature contractions and couplets decreased from 13,979 +/- 8964 (mean +/- SD) to 382 +/- 265 (P < 0.001), and from 516 +/- 274 to 9 +/- 6 (P < 0.001), respectively; runs of ventricular tachycardia (41.9 +/- 14.2) disappeared by the fifth day of treatment. The efficacy of antiarrhythmic treatment was evaluated by 24 h Holter monitoring obtained in baseline conditions and after 3, 5 and 10 d from beginning of therapy. In patients with TdP, Mg infusions were instituted at a slow rate (50 mg/min) and continued for 2 h after disappearance of Tdp, which occurred within 20 to 30 min from the start of the Mg infusions. These were followed by prophylactic infusions at rate of 30 mg/min for 90 min twice a day over the next 3 to 4 d. No side effects were observed, and heart rate and QTc remained unchanged from baseline values. In conclusion, Mg infusions may be an effective antiarrhythmic treatment for short and medium-term control of severe ventricular arrhythmias associated with IDC, and may prove useful in the acute treatment of TdP, especially in situations where conventional therapy might prove deleterious or difficult.
对20例患有缺血性扩张型心肌病（IDC）且伴有严重室性心律失常的血镁正常患者，以及10例在获得性QT间期延长情况下发生尖端扭转型室速（TdP）的患者，进行了抗心律失常镁（Mg）治疗评估。在IDC组中，硫酸镁以缓慢输注（60分钟内50毫克/分钟）的方式，每天两次，持续7天。这对所有患者均有抗心律失常作用：室性早搏和成对室性早搏分别从13,979±8964（平均值±标准差）降至382±265（P<0.001），以及从516±274降至9±6（P<0.001）；室性心动过速发作次数（41.9±14.2）在治疗第5天时消失。通过在基线条件下以及治疗开始后3天、5天和10天进行的24小时动态心电图监测来评估抗心律失常治疗的效果。对于TdP患者，以缓慢速率（50毫克/分钟）输注镁，并在TdP消失后持续2小时，TdP在镁输注开始后20至30分钟内消失。随后在接下来的3至4天内，以30毫克/分钟的速率进行预防性输注，每天两次，持续90分钟。未观察到副作用，心率和QTc与基线值相比保持不变。总之，输注镁可能是有效控制与IDC相关的严重室性心律失常的短期和中期抗心律失常治疗方法，并且可能在TdP的急性治疗中证明有用，特别是在传统疗法可能有害或困难的情况下。
