From the Guidelines
Magnesium can be used to treat palpitations in certain cases, particularly when they are related to magnesium deficiency or specific arrhythmias, such as torsades de pointes. The use of magnesium in treating palpitations is supported by several studies, including the 2018 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death 1. According to this guideline, intravenous magnesium can suppress episodes of torsades de pointes without necessarily shortening QT, even when serum magnesium is normal. Some key points to consider when using magnesium to treat palpitations include:
- Magnesium supplements typically come as magnesium oxide, citrate, or glycinate, with common dosages ranging from 200-400mg daily.
- For acute palpitations, healthcare providers might administer intravenous magnesium sulfate in clinical settings.
- Magnesium works by stabilizing cardiac cell membranes and regulating electrical impulses in the heart, which can reduce irregular heartbeats.
- Before starting any magnesium supplementation, it is crucial to consult with a healthcare provider, as excessive magnesium can cause side effects like diarrhea, nausea, and abdominal cramping, especially in patients with kidney disease 1. It is also important to note that magnesium is not appropriate for all types of palpitations, and its effectiveness varies by individual. While magnesium may help some people with palpitations, it is crucial to identify and address the underlying cause rather than just treating symptoms. Additionally, the use of magnesium in cardiac arrest due to any presenting rhythm has not been found to increase rates of return of spontaneous circulation (ROSC) or improve survival to hospital discharge or neurologic outcome 1.
From the Research
Magnesium and Palpitations
- Magnesium plays a significant role in treating cardiac arrhythmias, including palpitations, by increasing the ventricular threshold for fibrillation and prolonging sinus node refractoriness and conduction in the AV node 2.
- Studies have shown that oral magnesium can reduce the incidence of extrasystoles and alleviate symptoms in patients with symptomatic extrasystoles 2.
- Low magnesium concentrations can cause cardiac arrhythmias and interfere with the efficacy of antiarrhythmic drugs, making magnesium supplementation crucial in patients with hypomagnesemia 3.
- Magnesium has been used to treat ventricular arrhythmias due to digoxin toxicity, even in patients with slightly elevated serum magnesium levels 4.
- Intravenous magnesium has been shown to be effective in treating cardiac arrhythmias, including those caused by flecainide, and can be used as a therapeutic intervention in emergency situations 5.
- Magnesium therapy may be justified in patients with prolonged QT intervals, cardiac arrhythmias, and hypokalemia with hypomagnesemia, as it can help alleviate symptoms and prevent further complications 6.
Treatment of Palpitations with Magnesium
- Intravenous magnesium can be used to treat various types of cardiac arrhythmias, including Torsade de pointes tachycardias, digitalis toxicity-induced tachyarrhythmias, and multifocal atrial tachycardias 2.
- Oral magnesium can be used for long-term management of symptomatic extrasystoles and to reduce the incidence of arrhythmic events 2.
- Magnesium sulfate can be used to treat ventricular arrhythmias due to digoxin toxicity, especially when digoxin antibodies are not available 4.
- Magnesium glutamate can be used to treat ventricular tachycardia and ventricular fibrillation caused by flecainide 5.