6/28/23, 11:01 PM LOMAGHI (high-dose MgSO4) Pathway Feedback Search Clinical Topics Home Studies LOMAGHI (high-dose MgSO4 LOMAGHI (high-dose MgSO4 Disease Atrial fibrillation Trial question What is the role of high-dose magnesium sulfate in patients with rapid AF of > 120 beats/min? Study design Multi-center Double blinded RCT Population Characteristics of study participants 40.0% female N = 302 60.0% male 302 patients (121 female, 181 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=153 high-dose magnesium (9 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/recxemkVhBPLVinbL 1/2 6/28/23, 11:01 PM LOMAGHI (high-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 59.5 % 59.5 44.6 % 43.6 29.8 % 14.9 % Borderline significant increase 0.0 % High-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 (59.5% vs. 43.6%; RR 1.89, 95% CI 1.2 to 2.99) 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 (94.1% vs. 83.3%; RR 3.22, 95% CI 1.45 to 7.17) Safety outcomes Significant difference in adverse events (13.7% vs. 2.0%). Conclusion In adult patients admitted to the emergency department for rapid AF of > 120 beats/min, high-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/recxemkVhBPLVinbL 2/2