The Role of Postoperative Magnesium Infusion in Minimizing Ventricular Arrhythmia Risk after Cardiopulmonary Bypass

Abstract

Introduction: Cardiopulmonary bypass increases the incidence of postoperative ventricular arrhythmias in cardiac surgery. Magnesium, which is essential for cardiac function and may prevent arrhythmias, is frequently reduced after cardiac surgery. Aim of the Study: This study aimed to investigate the preventive effects of magnesium infusion in reducing the occurrence of ventricular arrhythmias in individuals who have undergone cardiopulmonary bypass. Methods: This study, done at Bangabandhu Sheikh Mujib Medical University, Dhaka, from July 2020 to June 2022, involved 120 participants in two groups: one received magnesium sulfate following standard cardiopulmonary bypass surgery (Group A), and the other did not (Group B). Both groups were monitored in the ICU with continuous ECG tracking and assessed for ventricular arrhythmias postoperatively on days 0–3. The inclusion criteria comprised adult cardiac patients in preoperative sinus rhythm with normal magnesium levels, excluding those with a history of ventricular arrhythmias or specific medical conditions. Data collected through a questionnaire, interviews, and medical records were analyzed using SPSS version 26. Result: The mean age of the patients in Group A was 53.83±14.54 years and in Group B was 54.50 ± 10.50 years. The mean difference in postoperative Mg++ was statistically significant (p<0.05) in POD 0, POD 1, POD 2, and POD 3. In this study, there were more VA-positive patients in Group B than in Group A; 16.67% had positive ventricular arrhythmia (PVC 8.3%, VT 3.33%, VF 5.00%), while 83.33% were negative VA. Group B had 66.67% negative VA and 33.33% positive VA (PVC 15.00%, VT 10.00%, VF 8.33%). Conclusion: This study identified that the postoperative Mg infusion after cardio pulmonary bypass reduces the incidence of postoperative arrhythmias in cardiac patients. Based on the findings, we recommend using intravenous magnesium as an alternative to prevent ventricular arrhythmias after CPB in cardiac patients.