Jeffrey B Washam1, Manesh R Patel2. 1. Duke Heart Center, Duke University Medical Center, Box 3943, Durham, NC, 27710, USA. jeff.washam@duke.edu. 2. Division of Cardiology, Duke University School of Medicine, Duke Clinical Research Institute, Duke Heart Center, Durham, NC, USA.
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. 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.
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 fibrillationpatients without heart failure. In atrial fibrillationpatients with heart failure, while the weight of evidence suggested an associated risk with digoxin therapy, the results are inconsistent. In patients with atrial fibrillation without heart failure, digoxin should generally be avoided. In atrial fibrillationpatients 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.
Authors: Craig T January; L Samuel Wann; Joseph S Alpert; Hugh Calkins; Joaquin E Cigarroa; Joseph C Cleveland; Jamie B Conti; Patrick T Ellinor; Michael D Ezekowitz; Michael E Field; Katherine T Murray; Ralph L Sacco; William G Stevenson; Patrick J Tchou; Cynthia M Tracy; Clyde W Yancy Journal: J Am Coll Cardiol Date: 2014-03-28 Impact factor: 24.094
Authors: Renato D Lopes; Roberto Rordorf; Gaetano M De Ferrari; Sergio Leonardi; Laine Thomas; Daniel M Wojdyla; Peter Ridefelt; John H Lawrence; Raffaele De Caterina; Dragos Vinereanu; Michael Hanna; Greg Flaker; Sana M Al-Khatib; Stefan H Hohnloser; John H Alexander; Christopher B Granger; Lars Wallentin Journal: J Am Coll Cardiol Date: 2018-03-13 Impact factor: 24.094
Authors: Bart A Mulder; Dirk J Van Veldhuisen; Harry J G M Crijns; Jan G P Tijssen; Hans L Hillege; Marco Alings; Michiel Rienstra; Maarten P Van den Berg; Isabelle C Van Gelder Journal: Heart Rhythm Date: 2014-06-09 Impact factor: 6.343
Authors: Stefan H Hohnloser; Jonathan L Halperin; A John Camm; Peggy Gao; David Radzik; Stuart J Connolly Journal: Circ Arrhythm Electrophysiol Date: 2014-11-06
Authors: James V Freeman; Kristi Reynolds; Margaret Fang; Natalia Udaltsova; Anthony Steimle; Niela K Pomernacki; Leila H Borowsky; Teresa N Harrison; Daniel E Singer; Alan S Go Journal: Circ Arrhythm Electrophysiol Date: 2014-11-20
Authors: Robert P Giugliano; Christian T Ruff; Eugene Braunwald; Sabina A Murphy; Stephen D Wiviott; Jonathan L Halperin; Albert L Waldo; Michael D Ezekowitz; Jeffrey I Weitz; Jindřich Špinar; Witold Ruzyllo; Mikhail Ruda; Yukihiro Koretsune; Joshua Betcher; Minggao Shi; Laura T Grip; Shirali P Patel; Indravadan Patel; James J Hanyok; Michele Mercuri; Elliott M Antman Journal: N Engl J Med Date: 2013-11-19 Impact factor: 91.245
Authors: Francisco Triana-Martínez; Pilar Picallos-Rabina; Sabela Da Silva-Álvarez; Federico Pietrocola; Susana Llanos; Verónica Rodilla; Enrica Soprano; Pablo Pedrosa; Alba Ferreirós; Marta Barradas; Fernanda Hernández-González; Marta Lalinde; Neus Prats; Cristina Bernadó; Patricia González; María Gómez; Maria P Ikonomopoulou; Pablo J Fernández-Marcos; Tomás García-Caballero; Pablo Del Pino; Joaquín Arribas; Anxo Vidal; Miguel González-Barcia; Manuel Serrano; María I Loza; Eduardo Domínguez; Manuel Collado Journal: Nat Commun Date: 2019-10-21 Impact factor: 14.919