6/28/23, 11:01 PM LOMAGHI (low-dose MgSO4) Pathway Feedback Search Clinical Topics Home Studies LOMAGHI (low-dose MgSO4 LOMAGHI (low-dose MgSO4 Disease Atrial fibrillation Trial question What is the role of low-dose magnesium sulfate in patients with rapid AF of > 120 beats/min? Study design Multi-center Double blinded RCT Population Characteristics of study participants 41.0% female N = 297 59.0% male 297 patients (123 female, 174 male) Inclusion criteria: adult patients admitted to the emergency department for rapid AF of > 120 beats/min Key exclusion criteria: arterial hypotension; impaired consciousness; renal failure; wide-complex ventricular response; contraindication to magnesium sulfate Interventions N=148 low-dose magnesium (4.5 g intravenous magnesium sulfate in 100 mL of normal saline plus atrioventricular nodal blocking agents) N=149 placebo (100 mL of intravenous normal saline plus atrioventricular nodal blocking agents) Primary outcome https://web.pathway.md/studies/recw3tCsjVVFxFblu 1/2 6/28/23, 11:01 PM LOMAGHI (low-dose MgSO4) Pathway Composite outcome of reduction of baseline ventricular rate to 90 beats/min, or reduction of VR by 20% from baseline at 4 hours 64.2 % 64.2 48.2 % 43.6 32.1 % 16.1 % Borderline significant increase 0.0 % Low-dose magnesium Placebo Borderline significant increase in composite outcome of reduction of baseline ventricular rate to 90 beats/min, or reduction of VR by 20% from baseline at 4 hours (64.2% vs. 43.6%; RR 2.31, 95% CI 1.45 to 3.69) Secondary outcomes Borderline significant increase in composite outcome of reduction of baseline ventricular rate to 90 beats/min, or reduction of VR by 20% from baseline at 24 hours (97.9% vs. 83.3%; RR 9.74, 95% CI 2.87 to 17.05) No significant difference in resolution time (6.1 hours vs. 8.4 hours; AD -2.3 hours, 95% CI -4.6 to 0) Significant increase in sinus rhythm control rate at 24 hours (22.9% vs. 10.7%; AD 12.2%, 95% CI 3.69 to 20.71) Safety outcomes No significant difference in adverse events. Conclusion In adult patients admitted to the emergency department for rapid AF of > 120 beats/min, low-dose magnesium was superior to placebo with respect to the composite outcome of reduction of baseline ventricular rate to 90 beats/min, or reduction of VR by 20% from baseline at 4 hours. Reference Wahid Bouida, Kaouthar Beltaief, Mohamed Amine Msolli et al. Low-dose Magnesium Sulfate Versus High Dose in the Early Management of Rapid Atrial Fibrillation: Randomized Controlled Double-blind Study (LOMAGHI Study). Acad Emerg Med. 2019 Feb;26(2):183-191. Open reference URL https://web.pathway.md/studies/recw3tCsjVVFxFblu 2/2