Mag for A fib w/RVR

TNFireMedic

Forum Ride Along
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So my service is looking to update our protocols and one of the other medics mentioned adding mag sulfate for a fib w/ RVR. From what we’ve found there’s some research that relates mag to rate reduction in new onset a fib and a flutter with less hemodynamic changes than seen in calcium channel blockers. Anybody else have any experience with this?
 

zacdav89

Forum Crew Member
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I don't personally have any experience with it but I did find an article that may give a perspective on its use.

http://circep.ahajournals.org/content/9/9/e004521

From what I skimmed there may be some studies out there looking at mag in conjunction to electrical or chemical conversion but I didn't see a suggestion for its use as a conversion agent it's self.
 

Peak

ED/Prehospital Registered Nurse
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Mag is part of our standard lab testing for cardiac cases but unless it is low we don't give it.

We typically use dilt, although with the shortage we have been using more beta-blockers.
 

E tank

Caution: Paralyzing Agent
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MgSo4 has it's place in very specific circumstances, but I can't think of a drug that causes so much excitement but delivers so little. For all of the "adjunct" roles it plays, it only ever turns out to be just OK and there are other agents that definitively deliver for the problem at hand. This is a good example of that. There are so many effective and predictable treatments for RVR AF, why there is academic interest in mag is beyond me.
 

coolidge

Forum Crew Member
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MgSo4 has it's place in very specific circumstances, but I can't think of a drug that causes so much excitement but delivers so little. For all of the "adjunct" roles it plays, it only ever turns out to be just OK and there are other agents that definitively deliver for the problem at hand. This is a good example of that. There are so many effective and predictable treatments for RVR AF, why there is academic interest in mag is beyond me.
Must never have talked to an afib patient who use magnesium....
 
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