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Serum magnesium and AF risk

Low levels of serum magnesium are associated with an increased risk of developing atrial fibrillation (AF), according to an analysis1 of the Framingham Offspring Study published recently in Circulation.

The investigators, led by Dr Abigail May Khan (University of Pennsylvania, Philadelphia), studied 3,530 participants who had a routine examination and were free of AF and cardiovascular disease at baseline. The average serum magnesium level was 1.88 mg/dL. During nearly 20 years of follow-up, 228 individuals developed AF, which was diagnosed using an electrocardiogram obtained during a Framingham clinic visit, inpatient hospitalisation, outpatient visit to a physician, or by Holter monitor.

The age- and sex-adjusted incidence of AF was 9.4 per 1000 person-years among individuals with serum magnesium <1.77 mg/dL and 6.3 per 1,000 person-years among those with levels >1.99 mg/dL. Compared with individuals in the highest quartile for serum magnesium, those with levels <1.77 mg/dL had a 54% increased risk of developing AF (p=0.02). There was no association between serum potassium or calcium and AF.

Researchers note that low levels of magnesium have been linked to the development of arrhythmias in experimental studies and that low serum magnesium is associated with an increased risk of AF following coronary artery bypass graft (CABG) surgery. They add that magnesium plays a role in the heart’s conduction system, including the sodium-potassium ATP pump. Disrupting or altering the function of the pump due to low magnesium levels might play a role in myocardial excitability, they observe.

“If confirmed, our observations may have important public-health implications, because the prevalence of AF is increasing, and magnesium deficiency is common and potentially modifiable,” according to the authors. “Further studies are warranted to determine whether the association is present in other populations and whether magnesium supplementation lowers AF risk”.


1. Khan AM, Lubitz SA, Sullivan LM, et al. Low serum magnesium and the development of atrial fibrillation in the community: The Framingham Heart Study. Circulation 2012.

Published on: December 20, 2012

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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