The Role of Hypomagnesemia in Cardiac Arrhythmias: A Clinical Perspective

• Published in: Biomedicines Vol. 10; no. 10; p. 2356
• Main Authors: Negru, Alina Gabriela, Pastorcici, Anda, Crisan, Simina, Cismaru, Gabriel, Popescu, Florina Georgeta, Luca, Constantin Tudor
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 21.09.2022; MDPI
• Subjects: Action potential; Alcohol; Arrhythmia; Asymptomatic; Cardiac arrhythmia; Clinical trials; Electrolytes; Energy metabolism; Fibrillation; Heart attacks; Heart rate; Hypertension; Hypocalcemia; Hypokalemia; Hypomagnesemia; Intravenous administration; Magnesium; magnesium supplementation; Metabolism; Mortality; Myocardial infarction; Physiological aspects; Review; Supplements; supraventricular arrhythmia; Tachycardia; torsade de pointes; Torsades de pointes; Ventricle; ventricular arrhythmia; ventricular tachycardia; Romania; ventricular arrhythmia; hypomagnesemia; supraventricular arrhythmia; torsade de pointes; ventricular tachycardia; magnesium supplementation
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines10102356

The importance of magnesium (Mg ), a micronutrient implicated in maintaining and establishing a normal heart rhythm, is still controversial. It is known that magnesium is the cofactor of 600 and the activator of another 200 enzymatic reactions in the human organism. Hypomagnesemia can be linked to many factors, causing disturbances in energy metabolism, ion channel exchanges, action potential alteration and myocardial cell instability, all mostly leading to ventricular arrhythmia. This review article focuses on identifying evidence-based implications of Mg in cardiac arrhythmias. The main identified benefits of magnesemia correction are linked to controlling ventricular response in atrial fibrillation, decreasing the recurrence of ventricular ectopies and stopping episodes of the particular form of ventricular arrhythmia called torsade de pointes. Magnesium has also been described to have beneficial effects on the incidence of polymorphic ventricular tachycardia and supraventricular tachycardia. The implication of hypomagnesemia in the genesis of atrial fibrillation is well established; however, even if magnesium supplementation for rhythm control, cardioversion facility or cardioversion success/recurrence of AF after cardiac surgery and rate control during AF showed some benefit, it remains controversial. Although small randomised clinical trials showed a reduction in mortality when magnesium was administered to patients with acute myocardial infarction, the large randomised clinical trials failed to show any benefit of the administration of intravenous magnesium over placebo.