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Is There Still a Role for Digoxin in the Management of Atrial Fibrillation?

  • Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

A number of recent observational analyses have assessed clinical outcomes associated with digoxin use in patients with atrial fibrillation. In this review, we review these data and provide suggestions on the contemporary use of digoxin in patients with atrial fibrillation as supported by the recent evidence.

Recent Findings

Observational data from clinical trials and registries have provided variable results on the safety and efficacy of chronic digoxin use in patients with atrial fibrillation. In general, results have been consistent with an associated increase in adverse clinical outcomes with digoxin use in atrial fibrillation patients without heart failure. In atrial fibrillation patients with heart failure, while the weight of evidence suggested an associated risk with digoxin therapy, the results are inconsistent.

Summary

In patients with atrial fibrillation without heart failure, digoxin should generally be avoided. In atrial fibrillation patients with heart failure, digoxin should generally be reserved for patients that do not achieve adequate rate control or are not tolerant of other rate control therapies.

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Papers of particular interest, published recently, have been highlighted as: • Of importance

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Authors and Affiliations

  1. Duke Heart Center, Duke University Medical Center, Box 3943, Durham, NC, 27710, USA

    Jeffrey B. Washam

  2. Division of Cardiology, Duke University School of Medicine, Duke Clinical Research Institute, Duke Heart Center, Durham, NC, USA

    Manesh R. Patel

Authors
  1. Jeffrey B. Washam
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  2. Manesh R. Patel
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Corresponding author

Correspondence to Jeffrey B. Washam.

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Conflict of Interest

Jeffrey B. Washam declares no conflicts of interest.

Manesh R. Patel reports grants and personal fees from Bayer Pharmaceuticals, Janssen, and AstraZeneca; and grants from HeartFlow and NHLBI.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Invasive Electrophysiology and Pacing

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Washam, J.B., Patel, M.R. Is There Still a Role for Digoxin in the Management of Atrial Fibrillation?. Curr Cardiol Rep 20, 105 (2018). https://doi.org/10.1007/s11886-018-1047-y

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  • DOI: https://doi.org/10.1007/s11886-018-1047-y

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