Low Versus High Dose Magnesium Sulfate in the Early Management of Rapid Atrial Fibrillation
Recruitment status was Not yet recruiting
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Purpose
Objective:
To assess the efficacy and the safety of high (9g) and low dose (4.5g) of MgS in the immediate treatment of rapid AF.
| Condition | Intervention | Phase |
|---|---|---|
|
Atrial Fibrillation |
Drug: sulfate magnesium Drug: magnesium sulfate |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Low Versus High Dose Magnesium Sulfate in the Early Management of Rapid Atrial Fibrillation : Randomised Controlled Double Blind Study (LOMAGHI Study) |
- Rhythm control: rate and delay of return to sinusal rhythm. Rate control: reduction of heart rate (HR <100 bpm or 20% reduction from baseline) [ Time Frame: 24 hours ] [ Designated as safety issue: No ]
- Arterial hypotension Bradycardia (HR <45 bpm) Other (chest pain, allergic reaction……) [ Time Frame: 24 hours ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 300 |
| Study Start Date: | August 2009 |
| Estimated Study Completion Date: | December 2010 |
| Estimated Primary Completion Date: | December 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: high magnesium sulfate infusion
9 g Magnesium sulfate
|
Drug: sulfate magnesium
9 g infusion once during 30 minutes
Other Name: high dose magnesium sulfate
|
|
Active Comparator: low magnesium sulfate infusion
4.5 magnesium sulfate infusion
|
Drug: magnesium sulfate
4.5 g magnesium sulfate infusion
|
Detailed Description:
Introduction:
Atrial fibrillation (AF) is a potentially life-threatening cardiac arrhythmia and a frequent chief complaint in emergency departments (ED). It is an important concern for a substantial proportion of people worldwide. According to the Rotterdam study, the prevalence of AF among individuals aged between 55 to 59 years is estimated at 1.1 for 1000 persons/year and 20.7 for individuals between 80 and 84 years. Given current adult ACLS, the immediate clinical objective in rapid AF is to achieve ventricular rate control. Digoxin, beta blockers and calcium channel antagonists are the most widely used agents for the emergent treatment of rapid AF. However, their effect is limited because only half of the patients will acutely respond to the first intention treatment. Several studies showed that the magnesium sulfate (MgS) is beneficial in the control of the rate and the rhythm of AF. In addition, hypomagnesemia is present among patients having AF in 20 to 53% of the cases . The association of hypomagnesemia and AF is common after a cardiac surgery and the prophylactic administration of MgS could be useful in post-operative AF .
The last meta analysis published in 2007 showed that the MgS is as well efficient in rate control (OR = 1.96) as in rhythm control (OR = 1.60) of AF. However most studies included in this meta analysis were conducted on limited number of patients (303 patients included for rate control outcome analysis and 376 for rhythm control). Consequently we need further randomized controlled studies to establish definitively the efficacy and the safety of MgS in the early management of rapid AF.
Objective:
To assess the efficacy and the safety of high (9g) and low dose (4.5g) of MgS in the immediate treatment of rapid AF.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- All patients presenting to ED with rapid AF (Heart rate >120 bpm).
Exclusion Criteria:
- Unstable hemodynamic state.
- Renal insufficiency (creatinemia> 180 µmol/l).
- Allergy to MgS.
Contacts and Locations| Contact: nouira semir, MD | 216532014 | semir.nouira@rns.tn |
| Principal Investigator: | nouira semir, MD | University of Monastir |
More Information
No publications provided
| Responsible Party: | research ministry, University of Monastir |
| ClinicalTrials.gov Identifier: | NCT00965874 History of Changes |
| Other Study ID Numbers: | LOMAGHI |
| Study First Received: | August 24, 2009 |
| Last Updated: | August 25, 2009 |
| Health Authority: | Tunisia: Ministry of Public Health |
Keywords provided by University of Monastir:
|
Rapid Atrial Fibrillation Magnesium Sulfate Cardiac arrhythmia |
Additional relevant MeSH terms:
|
Atrial Fibrillation Arrhythmias, Cardiac Heart Diseases Cardiovascular Diseases Pathologic Processes Magnesium Sulfate Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents |
Therapeutic Uses Anesthetics Central Nervous System Depressants Anti-Arrhythmia Agents Cardiovascular Agents Anticonvulsants Calcium Channel Blockers Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action Tocolytic Agents Reproductive Control Agents |
ClinicalTrials.gov processed this record on May 21, 2013