A Meta Analysis Of Effectiveness And Security Of Ibutilide With Magensium Versus Iubutilide Alone On Atrial Fibrillation/Flutter

Objective: To analyze the efficacy and safety of ibutilide with magensium versus iubutilide alone on atrial fibrillation /flutter.Methods: We searched Pub Med, medline,Cochrane, wanfang, huipu and zhiwang databases to find article about compared the efficacy and safety of magnesium with ibutilide versus ibutilide alone in the treatmente of atrial fibrillation and flutter published from Ianuary 2003 to Ianuary 2014,including both English and Chinese randomized controlled trials(RCTs),using the key words magnesium ibutilide atrial fibrillation and atrial flutter. Two investigators independently reviewed the studies. Eight studies were included in the final meta analysis.Results:Compared to ibutilide alone, concomitanttion of intravenous magnesium with ibutilide significantly increases the efficacy of conversion to sinus rhythm(OR = 1.68, 95% CI 1.34-2.12, P<0.05). Compared to ibutilide alone, concomitanttion of intravenous magnesium with ibutilide significantly increases the efficacy of atrial fibrillation conversion to sinus rhythm(OR=1.05, 95% CI 0.42~2.63, P>0.05).Compared to ibutilide alone, concomitanttion of intravenous magnesium with ibutilide significantly increases the efficacy of atrial flutter conversion to sinus rhythm(OR = 2.15, 95% CI 1.06-4.33, P<0.05). The incidence of ventricular arrhythmias was significantly reduced with magnesium(4.3% vs 8.5%;OR=0.43, 95% CI 0.26~0.72, P<0.05),There were no significant side effects with magnesium use identified in these studies.There were differences for the openning of TDP between two groups(0% vs 0.3%;OR= 0.21, 95% CI 0.07~0.68, P<0.05).Conclusion:Intravenous magnesium safely and significantly enhances the efficacy of ibutilide in the conversion of atrial fibrillation /flutter.