Zehender M
Innere Medizin III, Universitätsklinik Freiburg, FRG.
Z Kardiol. 1996;85 Suppl 6:135-45.
The use of magnesium as an antiarrhythmic agent in ventricular and supraventricular arrhythmias is a matter of an increasing but still controversial discussion during recent years. With regard to the well established importance of magnesium in experimental studies for preserving electrical stability and function of myocardial cells and tissue, the use of magnesium for treating one or the other arrhythmia seems to be a valid concept. In addition, magnesium application represents a physiologic approach, and by this, is simple, cost-effective and safe for the patient. However, when one reviews the available data from controlled studies on the antiarrhythmic effects of magnesium, there are only a few types of cardiac arrhythmias, such as torsade de pointes, digitalis-induced ventricular arrhythmias and ventricular arrhythmias occurring in the presence of heart failure or during the perioperative state, in which the antiarrhythmic benefit of magnesium has been shown and/or established. Particularly in patients with one of these types of cardiac arrhythmias, however, it should be realized that preventing the patient from a magnesium deficit is the first, and the application of magnesium the second best strategy to keep the patient free from cardiac arrhythmias.
近年来,镁作为一种抗心律失常药物用于治疗室性和室上性心律失常,这一话题的讨论日益增多,但仍存在争议。鉴于镁在实验研究中对维持心肌细胞和组织的电稳定性及功能具有公认的重要性,使用镁来治疗某种心律失常似乎是一个合理的概念。此外,应用镁是一种生理性方法,因此对患者来说简单、经济且安全。然而,当回顾关于镁抗心律失常作用的对照研究的现有数据时,只有少数几种心律失常,如尖端扭转型室速、洋地黄所致室性心律失常以及心力衰竭时或围手术期出现的室性心律失常,镁的抗心律失常益处已得到证实和/或确立。然而,特别是对于患有这些类型心律失常之一的患者,应该认识到,防止患者出现镁缺乏是首要策略,而应用镁是使患者免于心律失常的次优策略。