Effect of magnesium sulfate on ventricular rate control in atrial fibrillation

Ann Emerg Med. 1994 Jul;24(1):61-4. doi: 10.1016/s0196-0644(94)70163-6.


Study objectives: The objectives of this study were to assess the efficacy of parenteral magnesium sulfate (MgSO4), digoxin, and combined MgSO4-digoxin therapies in acutely lowering ventricular rates in patients with newly recognized atrial fibrillation.

Design: A randomized, double-blinded, placebo-controlled clinical study.

Setting: US Army tertiary care facility.

Participants: Fifteen adults (mean age, 62 +/- 19 years) presenting with newly recognized atrial fibrillation and rapid ventricular rate (more than 99).

Interventions: Patients were given an initial parenteral MgSO4 bolus with continuous infusion or placebo. After 30 minutes, all patients were given 0.5 mg IV digoxin and followed for 3.5 hours.

Measurements and main results: Ventricular rates were obtained at baseline, every 5 minutes for the first 30 minutes, and then every 30 minutes for 3.5 hours. At 5 minutes, ventricular rates decreased 16 +/- 7% (P < .02) with MgSO4; this was comparable with rate control with digoxin (18 +/- 9%) at 4 hours. Rate control tended (26 +/- 7%) to improve with combined therapy.

Conclusion: Parenteral MgSO4 may be useful in the acute management of rapid ventricular rates in patients with atrial fibrillation.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Atrial Fibrillation / drug therapy*
  • Atrial Fibrillation / physiopathology
  • Digoxin / pharmacology
  • Digoxin / therapeutic use*
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Heart Rate / drug effects*
  • Heart Ventricles / drug effects
  • Heart Ventricles / physiopathology
  • Humans
  • Magnesium Sulfate / pharmacology
  • Magnesium Sulfate / therapeutic use*
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome


  • Digoxin
  • Magnesium Sulfate