The study published in JAMA Network Open revealed that administering magnesium and potassium intravenously to patients with nonpermanent atrial fibrillation improved the likelihood that their condition will spontaneously convert to sinus rhythm (SVC).

The evaluation included 573 cases of non-permanent atrial flutter (AFL) and 2546 instances of non-permanent atrial fibrillation (AF). The patients received a 90-minute intravenous infusion of 2.5 mEq of potassium and 18.2 mg of magnesium along with 500 mL of a balanced crystalloid solution comprising 24 mEq of potassium and 145.8 mg of magnesium.

Results showed that SCV occurred in 15.4% of AF episodes and 12.7% of AFL episodes during the patients stay in the emergency department. In AF but not in AFL, intravenous potassium and magnesium increased the risk of SVC compared to no IV potassium and magnesium. Administration of intravenous potassium and magnesium was linked to a 19.2% increase in the probabilities of SVC in AF episodes, as opposed to a 10.4% increase with no administration. However, when compared to no treatment, no connection between the likelihood of SCV and the administration of potassium and magnesium was seen for AFL.

The results suggest that intravenous potassium and magnesium therapy was not linked with an increased risk of SCV in patients with AFL but were in patients with nonpermanent AF and plasma potassium levels between 3.50 and 3.99 mEq/L and less than or equal to 3.50 mEq/L. This strategy may reduce the requirement for pharmacologic intervention and minimize any potential negative effects of antiarrhythmic medication. Experts suggested conducting a randomized clinical trial to evaluate the effectiveness and safety of such a strategy.

(Source:

1.  https://www.medscape.com/viewarticle/983137?src=#vp_2
2. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797474 )