Magnesium therapy for torsades de pointes

Dan Tzivoni, Andre Keren, Amos Cohen, Hanan Loebel, Izhar Zahavi, Adrian Chenzbraun, Shlomo Stern

Research output: Contribution to journalArticlepeer-review

Abstract

This is the first report of the successful use of magnesium sulfate (MgSO4) in 3 consecutive patients with torsades de pointes (TdP). In 1 patient, TdP was induced by a combination of quinidine and amiodarone, in the second by procainamide, and in the third by an overdose of imipramine. The QT intervals before TdP were 0.70, 0.64 and 0.56 second, respectively. A bolus of 1.0 to 2.0 g MgSO4 25% abolished the TdP in all 3 patients; but in the third patient, because of recurrent TdP, a second bolus of 1.0 g and a continuous 24-hour infusion of 1.0 mg/min were administered, preventing TdP. There was no immediate shortening in the QT interval in any patient after MgSO4. Magnesium can be given safely even in patients with acute myocardial infarction, angina pectoris or systemic hypertension, conditions in which isoproterenol is contraindicated; it can be applied faster than temporary cardiac pacing; and its use for TdP appears worthy of additional trials.

Original languageEnglish
Pages (from-to)528-530
Number of pages3
JournalAmerican Journal of Cardiology
Volume53
Issue number4
DOIs
StatePublished - 1 Feb 1984
Externally publishedYes

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