Evidence supporting the use of: Magnesium
For the health condition: Arrhythmia

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Synopsis

Source of validity: Scientific
Rating (out of 5): 4

Magnesium is scientifically validated as a supportive treatment for certain types of arrhythmias, particularly in the management of torsades de pointes, a specific form of polymorphic ventricular tachycardia. Hypomagnesemia (low serum magnesium) is a known risk factor for various cardiac arrhythmias, and magnesium supplementation has been shown in clinical settings to reduce the incidence and severity of these disturbances. The American Heart Association and other cardiac societies recommend intravenous magnesium sulfate as first-line therapy for torsades de pointes, based on robust clinical evidence and expert consensus. Beyond this, magnesium may play a role in correcting arrhythmias associated with digitalis toxicity and in the perioperative setting, especially in patients with documented magnesium deficiency.

However, the evidence for routine magnesium supplementation in other arrhythmias (e.g., atrial fibrillation in patients without deficiency) is less robust, with some studies suggesting modest benefit but not enough to support widespread use. Overall, the mechanism involves magnesium’s effect on cardiac ion channels, stabilizing myocardial cell membranes, and modulating electrical activity. Meta-analyses and randomized trials support its use in specific, well-defined situations rather than as a universal antiarrhythmic. Therefore, while magnesium is not a panacea for all arrhythmias, its role in certain contexts is supported by solid scientific evidence.

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