THE EFFICACY OF INTRAVENOUS POTASSIUM AND MAGNESIUM GLUCONATE IN PATIENTS WITH NON-VALVULAR PERSISTENT ATRIAL FIBRILLATION AFTER CARDIOVERSION WITH AMIODARON
Background: Atrial fibrillation (AF) is one of the most common arrhythmia in cardiology practice that frequently recurs after restoration of sinus rhythm. Amiodarone treatment is often effective for restoration and maintenance of sinus rhythm in patients with persistent AF but is also associated with high rate of recurrences. The aim of this study was to evaluate the efficacy of potassium and magnesium gluconate supplement usage for the prevention of recurrent AF after amiodarone cardioversion.
Methods: The study includes 56 patients (24 women, 32 men, age 52,3 ± 9.6 years) without structural heart disease. Arter amiodarone cardioversion all patients were divided into two groups. First group (n=41) received combination of amiodarone together with potassium and magnesium gluconate intravenously (20 ml 10 % solution, 1,666 g magnesium gluconate and 0,334 g potassium gluconate) during 10-12 days. Patients from control group (n=15) continued to receive only amiodarone in similar dosages (400-600 mg daily). 24-hours ECG monitoring was provided 10-12 days after restoration of sinus rhythm.
Results: There were short AF paroxysms in 19 patients (33,9%) during Holter monitoring, asymptomatic AF recurrences were present in 12 (21,4 %) of patients overall. Compared to the control group, recurrences AF were significantly reduced with K/Mg gluconate addition (p<0.05). There were no significant differences in total amount of atrial and ventricular extasystoles in two groups.
Yet, supraventricular couplets, which may predict AF recurrences, were registered significantly less frequent in K/Mg gluconate group (p<0.05).
Conclusion: These results suggest that administration of intravenous K/Mg gluconate was significantly associated with decreased risk of AF recurrences in patients with persistent AF after amiodarone cardioversion. ECG should be continuously monitored after cardioversion in patients with persistent AF for timely diagnosis of asymptomatic AF.