Magnesium in Cardiovascular Disease
Journal of Clinical and Basic Cardiology 2002; 5 (1): 55-59
Keywords: Arrhythmie, Koronare Herzkrankheit, magnesium, arrhythmia, coronary artery disease, magnesium
In cardiovascular medicine, magnesium is of major importance in the treatment of arrhythmias and coronary artery disease. Magnesium raises the ventricular fibrillation threshold and prolongs the sinus node recovery time and atrioventricular conduction time. Main indications for magnesium are torsade de pointes tachycardias, digitalis induced ventricular tachyarrhythmias and multifocal atrial tachycardias. Additionally, magnesium has been used successfully in ventricular ectopies after overdose of neuroleptics or tricyclic antidepressants. Potential benefits can be expected in monomorphic ventricular tachycardias and in ventricular arrhythmias that did not respond to class III antiarrhythmic drugs. Recent studies have shown positive effects of magnesium in perioperative patients, where the incidence of atrial and ventricular arrhythmias could be reduced. Oral magnesium has been used for years in patients with premature ventricular beats (PVB). Several studies have shown, that combined oral therapy with magnesium and potassium can effectively reduce the incidence of PVB. Patients with coronary heart disease frequently suffer from magnesium deficiency. Oral combination therapy with magnesium and potassium improves the endothelial function in these patients and reduces platelet-dependent thrombosis. These encouraging results from basic science studies have now been confirmed in a large clinical trial showing that oral magnesium therapy improves exercise duration and quality of life in patients with coronary artery disease.