Antiarrhythmic effects of increasing the daily intake of magnesium and potassium in patients with frequent ventricular arrhythmias. Magnesium in Cardiac Arrhythmias (MAGICA) Investigators.

OBJECTIVES: This study sought to assess potential antiarrhythmic effects of an increase in the daily oral intake of magnesium and potassium in patients with frequent ventricular arrhythmias. BACKGROUND: Magnesium and potassium contribute essentially to the electrical stability of the heart. Despite experimental and clinical evidence for the antiarrhythmic properties of the two minerals, controlled data in patients with stable ventricular arrhythmias are lacking. METHODS: In a randomized, double-blind study, 232 patients with frequent ventricular arrhythmias (> 720 ventricular premature beats [VPBs]/24 h) confirmed at baseline and after 1 week of placebo therapy were subsequently treated over 3 weeks with either 6 mmol of magnesium/12 mmol of potassium-DL-hydrogenaspartate daily or placebo. RESULTS: Compared with placebo pretreatment, active therapy resulted in a median reduction of VPBs by -17.4% (p = 0.001); the suppression rate was 2.4 times greater than that in patients randomized to 3 weeks of placebo therapy (-7.4%, p = 0.038). The likelihood of a > or = 60% (predefined criterion) or > or = 70% suppression rate (calculated from the placebo-controlled run-in period) was 1.7 (25% vs. 15%, p = 0.044) and 1.5 times greater in the active than in the placebo group (20% vs. 13%, p = 0.085), respectively. No effect of magnesium and potassium administration was observed on the incidence of repetitive and supraventricular arrhythmias and clinical symptoms of the patients. CONCLUSIONS: To our knowledge, this study is the first to provide controlled data on the antiarrhythmic effect of oral administration of magnesium and potassium salts when directed to patients with frequent and stable ventricular tachyarrhythmias. A 50% increase in the recommended minimum daily dietary intake of the two minerals for 3 weeks results in a moderate but significant antiarrhythmic effect. However, with the given therapeutic regimen, repetitive tachyarrhythmias and patient symptoms remain unchanged.

Lack of psychotomimetic or impairing effects on psychomotor performance of acamprosate.

The possible effects on psychomotor performance, concentration, attention, and mood of acamprosate (calciumacetylhomotaurinate) were assessed using a randomized, double-blind, cross-over, placebo-controlled design involving 12 healthy male volunteers. Acamprosate 2 g daily per os or placebo was administered for seven days and separated by washout intervals of at least 21 days. Objective tests evaluated psychomotor functions (simple reaction time measurement, binary choice reaction test, computerized visual searching task, sustained attention test). Mood was assessed using the Beck Depression Inventory and the Beschwerde-Liste to assess subjective physical impairment. Additionally, a visual 3-D illusion paradigm was applied to measure the psychotomimetic effect. A dose of acamprosate of 2 g/day for seven days was free of any significant effects on mood, concentration, attention, psychomotor performance and did not produce any subjective sedation, excitation or psychotomimetic effects.