Safety and Efficacy of Intravenous Magnesium for Torsade de Pointes - A Scoping Review.
Level 4 - case-series / case-control
Scoping review synthesizing four uncontrolled observational studies/case series.
PubMed 41216399 · doi:10.1253/circrep.CR-25-0175
What was done
Authors conducted a scoping review following PRISMA extension guidelines to assess the safety and efficacy of intravenous magnesium for Torsade de Pointes (TdP). Four online databases were searched through November 27, 2024, identifying 4 observational studies that met inclusion criteria.
What was found
Across 4 observational studies comprising 46 total patients: - TdP resolved in 78.3% of patients treated with intravenous magnesium (36/46). - Progression to ventricular fibrillation occurred in 21.7% of patients (10/46). - Serious adverse events related to magnesium were reported in 0% of patients (0/46).
Why it matters
Despite standard guideline use of intravenous magnesium for TdP, systematic clinical evidence is remarkably sparse. These findings suggest reasonable efficacy and safety, but note that more than one in five patients still progresses to ventricular fibrillation, requiring immediate readiness for electrical defibrillation.
Limits
The total evidence base is limited to 4 studies with only 46 total patients. All included studies were observational, and most lacked a control group. Dosing regimens, baseline serum magnesium levels, underlying etiologies, and concurrent antiarrhythmic treatments were not reported in the abstract.
Cited by
- supports Intravenous magnesium is recommended by American Heart Association guidelines as the treatment for torsades de pointes.