Digoxin may not improve prognosis in AF

Digoxin may not improve prognosis in AF

Digoxin may not improve prognosis in AF: A 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 (adjusted hazard ratio=0.76; 95% confidence interval=0.74-0.78) and calcium channel blockers (adjusted hazard ratio=0.93; 95% confidence interval=0.90-0.96) were found to confer a lower risk of mortality compared to no treatment  while use of digoxin was associated with a poor prognosis (adjusted hazard ratio of 1.12; 95% confidence interval=1.10-1.14). 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.

Reference

1. Chao TF, Liu CJ, Tuan TC, Chen SJ, Wang KL, Lin YJ, Chang SL, Lo LW, Hu YF, Chen TJ, Chiang CE, Chen SA. Rate-Control Treatment and Mortality in Atrial Fibrillation. Circulation. 2015; 132: 1595-1596.