Digoxin may not improve prognosis in AF

A recent study published in Circulation [1] evaluated the use of various rate control modalities in atrial fibrillation. They evaluated the risk of mortality in a population based study of about 270 thousand patients. In this study, about 44 thousand received beta blockers while over 18 thousand received calcium channel blockers and about 39 thousand received digoxin. No rate reducing agents were received by about 169 thousand patients, which incidentally constituted the majority of this study population.
Use of beta blockers and calcium channel blockers were found to confer a lower risk of mortality compared to no treatment while use of digoxin was associated with a poor prognosis. Authors while calling for a prospective study endorsed the current guideline recommendation to use beta blockers and calcium channel blockers for rate control in atrial fibrillation.

  1. Chao TF et al. Rate-Control Treatment and Mortality in Atrial Fibrillation. Circulation. 2015; 132: 1595-1596.