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<p>New-onset atrial fibrillation (AF) is common in the intensive care unit (ICU) and is associated with increased morbidity and mortality. Although current international guidelines provide limited recommendations on magnesium sulfate (MgSO<sub>4</sub>) use in AF, emerging evidence suggests that high-dose intravenous magnesium may offer a safe and effective strategy for controlling ventricular rate and promoting rhythm conversion in critically ill patients. This perspective paper explores the electrophysiological rationale behind magnesium use, highlights key clinical studies supporting its efficacy, and calls for renewed attention to this underutilized therapeutic option. Given its favorable safety profile and low cost, high-dose magnesium warrants rigorous evaluation in randomized controlled trials (RCTs) and may represent a therapeutic option in future ICU-specific AF management protocols.</p>

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High-Dose Intravenous Magnesium for New-Onset Rapid Atrial Fibrillation in the ICU: An Overlooked Strategy?

  • 期刊论文

  • 发表日期：

    2025年9月13日

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  • Thanh Luan Nguyen

摘要

New-onset atrial fibrillation (AF) is common in the intensive care unit (ICU) and is associated with increased morbidity and mortality. Although current international guidelines provide limited recommendations on magnesium sulfate (MgSO4) use in AF, emerging evidence suggests that high-dose intravenous magnesium may offer a safe and effective strategy for controlling ventricular rate and promoting rhythm conversion in critically ill patients. This perspective paper explores the electrophysiological rationale behind magnesium use, highlights key clinical studies supporting its efficacy, and calls for renewed attention to this underutilized therapeutic option. Given its favorable safety profile and low cost, high-dose magnesium warrants rigorous evaluation in randomized controlled trials (RCTs) and may represent a therapeutic option in future ICU-specific AF management protocols.