Electrolyte disorders can alter cardiac ionic currents kinetics and depending on the changes can promote proarrhythmic or antiarrhythmic effects. The present report reviews the mechanisms, electrophysiolgical (EP), electrocardiographic (ECG), and clinical consequences of electrolyte disorders. Potassium (K⁺) is the most abundent intracellular cation and hypokalemia is the most commont electrolyte abnormality encountered in clinical practice. The most significant ECG manifestation of hypokalemia is a prominent U wave. Several cardiac and non cardiac drugs are known to suppress the HERG K⁺ channel and hence the I(K), and especially in the presence of hypokalemia, can result in prolonged action potential duration and QT interval, QTU alternans, early afterdepolarizations, and torsade de pointes ventricular tachyarrythmia (TdP VT). Hyperkalemia affects up to 8% of hospitalized patients mainly in the setting of compromised renal function. The ECG manifestation of hyperkalemia depends on serum K⁺ level. At 5.5-7.0 mmol/L K⁺, tall peaked, narrow-based T waves are seen. At > 10.0 mmol/L K⁺, sinus arrest, marked intraventricular conduction delay, ventricular techycardia, and ventricular fibrillation can develop. Isolated abnormalities of extracellular calcium (Ca⁺⁺) produce clinically significant EP effects only when they are extreme in either direction. Hypocalcemia, frequently seen in the setting of chronic renal insufficiency, results in prolonged ST segment and QT interval while hypercalcemia, usually seen with hyperparathyroidism, results in shortening of both intervals. Although magnesium is the second most abudent intracellular cation, the significance of magnesium disorders are controversial partly because of the frequent association of other electrolyte abnormalities. However, IV magnesium by blocking the L-type Ca(⁺⁺) current can successfully terminate TdP VT without affecting the prolonged QT interval. Finally, despite the frequency of sodium abnormalities, particularly hyponatremia, its EP effects are rarely clinically significant.

/pdf/electrolyte-disorders-and-arrhythmogenesis-53i2s9fyvw.pdf

Electrolyte disorders and arrhythmogenesis

Although the following text will focus on magnesium in disease, its role in healthy subjects during physical exercise when used as a supplement to enhance performance is also noteworthy. Low serum magnesium levels are associated with metabolic syndrome, Type 2 diabetes mellitus (T2DM) and hypertension; consequently, some individuals benefit from magnesium supplementation: increasing magnesium consumption appears to prevent high blood pressure, and higher serum magnesium levels are associated with a lower risk of developing a metabolic syndrome. There are, however, conflicting study results regarding magnesium administration with myocardial infarction with and without reperfusion therapy. There was a long controversy as to whether or not magnesium should be given as a first-line medication. As the most recent trials have not shown any difference in outcome, intravenous magnesium cannot be recommended in patients with myocardial infarction today. However, magnesium has its indication in patients with torsade de pointes and has been given successfully to patients with digoxin-induced arrhythmia or life-threatening ventricular arrhythmias. Magnesium sulphate as an intravenous infusion also has an important established therapeutic role in pregnant women with pre-eclampsia as it decreases the risk of eclamptic seizures by half compared with placebo.

Magnesium in disease.

A high serum chloride concentration has been associated with the development of acute kidney injury in critically ill patients. However, the association between hyperchloremia and acute kidney injury (AKI) in patients admitted with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) is unknown. A retrospective analysis of consecutive patients admitted with the diagnosis of STEMI and treated with PCI was performed. Subjects were classified as having hyper- or normochloremia based upon their admission serum chloride level. Multivariable logistic regression analyses were employed for the primary and secondary outcomes. The primary analysis evaluated whether high serum chloride on admission was associated with the development of AKI after adjusting for age, diabetes mellitus, admission systolic blood pressure, contrast volume used during angiography, Killip class, and need for vasopressor therapy or intraaortic balloon pump. The secondary analyses evaluated whether high serum chloride was associated with sustained ventricular tachycardia or fibrillation. Of 291 patients (26.1% female, mean age of 59.9 ± 12.6 years, and mean body mass index of 29.3 ± 6.1 kg/m(2)), 25 (8.6%) developed AKI. High serum chloride on admission did not contribute significantly to the development of AKI (odds ratio, 95%; confidence interval, 0.90 to 1.24). In addition, serum chloride on admission was not significantly associated with sustained ventricular tachycardia or fibrillation after adjusting for demographic and clinical covariates. In conclusion, our study demonstrated no association between baseline serum hyperchloremia and an increased risk of AKI in patients admitted with STEMI treated with PCI.

Serum hyperchloremia as a risk factor for acute kidney injury in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

\nMagnesium is an essential nutrient for the living organisms and plays an important part in the prevention and treatment of many diseases. It is an enzymatic cofactor for more than 300 reactions. Magnesium is essential for regulating blood pressure, muscle contraction, cardiac excitability, insulin metabolism, vasomotor tonus. Studying the way in which serum magnesium concentration varies in children and adolescents in the Sibiu area according to the reference intervals we especially set for this area. The study is a retrospective one, using approximately 4900 data from the archives of the Medical Analysis Laboratory within the Sibiu Pediatric Clinical Hospital. Serum magnesium was dosed using the Konelab Prime 30i analyser. The data from the literature was used to compare the results. The reference ranges obtained in the current study were similar to the literature studied. The percentage of patients with magnesium concentration outside the reference ranges was roughly equal for all age groups. The difference was between 1 month and 2 year-old children with very few deviations from the reference range. The results of our study reflect more accurately the real reference range for the population in the Sibiu area, helping clinicians to establish a diagnosis as quickly and accurate as possible. These results were not significantly different from the literature studied.\n

http://bch.ro/pdfRC/12 ANTONESCU 12 18.pdf

Study of the Total Serum Concentration of Serrum Ionized Magnesium in Children and Adolescents from Sibiu Area

Background: Organophosphorus (OP) poisoning is a common health problem. Its diagnosis depends on clinical findings. The main treatment of OP poisonings is atropine and oximes. However, new adjunct therapy such as magnesium sulfate (MgSO4) has been introduced. Materials and Methods: To detect the effects of MgSO4, a case–control study was conducted on 100 patients intoxicated with OP compounds. All patients received standard care of treatment while half of them received MgSO4 given in a dose of 1 g/6 h for 24 h. Results: The given atropine and oximes doses, hospitalization period, and incidence of complications, especially cardiac arrhythmias, respiratory failure, and death were significantly reduced in Mg-treated group. Conclusion: Results suggest that magnesium could ameliorate OP toxic effects and could be considered in the management of patients intoxicated with these compounds.

Clinical benefits of magnesium sulfate in management of acute organophosphorus poisoning

Magnesium plays an essential role in many fundamental biological reactions, as it is involved in more than 300 metabolic reactions. Deficiency of magnesium may result in many disorders, including cardiac arrhythmias. As intravenous magnesium has a high therapeutic to toxic ratio and a minimal negative inotropic effect, it has long been used in treatment and prevention of cardiac arrhythmias. Several studies have shown the beneficial effect of intravenous infusion of Mg during an attack of supraventricular tachycardia, indicating that the effectiveness of magnesium depends on the type of tachycardia. Magnesium has also an advantageous effect in the case of atrial fibrillation, considered a criterion of the effectiveness of atrial fibrillation acute treatment at the ventricular rate ≤ 100 min–1. As intravenous magnesium seems to be useful in prevention and treatment of various cardiac arrhythmias, it is a common component of a complex antiarrhythmic therapy.

http://yadda.icm.edu.pl/yadda/element/bwmeta1.element.agro-fa5a7986-5d67-4684-9e9b-823a970ca0d0/c/317-327.pdf

The role of magnesium in cardiac arrhythmias.

Handle everyday research tasks with reliable, citation-backed results

Your personal Research Agent to handle research tasks with citation-backed results

Popular Tasks used by Researchers

How can I help with your research?

Meet SciSpace

Get more enhanced response by uploading the PDFs you want me to reference.

No relevant PDFs in your library

SciSpace is the AI research assistant for academics. Run systematic literature reviews on 280M+ papers, and write papers with cited sources. Trusted by 1M+ students, PhDs & researchers.

SciSpace | AI for Research

Analyze PDFs

Code & Manuscripts

Funding & Grants

Literature & Patents

Medical & Clinical Data

Systematic Review

Visualize & Present

Web & Data

Build a Google Scholar-like website for your research.

Build a website

Create charts and images for your research

Create a Chart

Write a paper for submission to a journal

Draft a manuscript

Patent Search

Design eye-catching scientific posters in minutes.

Scientific Poster Generation

Systematic Literature Review

One task is running at the moment. Your messages will be shown right after.

Drag and drop or click here to browse

Loved by <highlight>1 million+</highlight> researchers

Extract a list of specific topics and their sources from unstructured text

Topics

Compare and analyze relevant papers that matches with your search

Papers

Get insights from PDFs and bookmarked papers from your library

My library

Recent searches

Try searching for:

Catch AI-generated content in scholarly and non-scholarly content

{ai} Detector

Ai Writer

Get PDF Summaries, highlighted text explanations 

Chat with PDF

Effortlessly create in-text citations and bibliographies in APA and 2,500 other formats

Citation generator

Get explanations, summaries, and answers on academic papers

Ease up your research workflow with {scispace}'s cohort of exciting AI tools

Elevate your academic writing skills and convey your ideas the way you want

Paraphraser

Explore our range of reading and writing tools

Your file is being prepared and should be ready in a few minutes. If it's a large file, it might take a bit longer. You can close this window, and we'll email you the file when it's done.

You have reached a maximum limit of <strong>{limit}</strong> columns in the table. Remove at least <strong>1</strong> column to add or create another one.

A. Cies

Author Tools

Chat about Author

Papers

The role of magnesium in cardiac arrhythmias.