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[Dynamic electrocardiogram in chronic atrial fibrillation treated with digitalis]
S Scardi1, F Humar, R Cesanelli
1Centro Cardiovascolare, Ospedale Maggiore, Trieste.
Giornale Italiano Di Cardiologia
|May 1, 1991
Summary
Patients with chronic atrial fibrillation on digoxin alone often experience high daytime heart rates, even when controlled. 24-hour Holter monitoring can identify patients who may benefit from additional medications like calcium-antagonists or beta-blockers.
Area of Science:
- Cardiology
- Clinical Electrophysiology
Background:
- Chronic atrial fibrillation (AF) management requires careful heart rate control.
- Digoxin is a common treatment for AF, but its effectiveness in controlling heart rate during daily activities needs further evaluation.
Purpose of the Study:
- To assess heart rate variability and patterns in patients with chronic atrial fibrillation.
- To evaluate the adequacy of daytime heart rate control in AF patients treated with digoxin monotherapy.
Main Methods:
- A 24-hour Holter monitoring was conducted on 60 patients with chronic atrial fibrillation and 25 healthy controls.
- Patients with AF had controlled heart rates on basal ECG, normal hematological and thyroid values, and received digoxin monotherapy.
Main Results:
- Patients with AF exhibited significantly higher daytime heart rates compared to healthy subjects.
- Up to 82% of AF patients had maximum heart rates exceeding 115 bpm during the day.
- 66% of AF patients experienced pauses between 2.0 and 3.0 seconds.
Conclusions:
- Digoxin monotherapy may not adequately control daytime heart rates in all patients with chronic atrial fibrillation.
- 24-hour Holter monitoring is recommended to identify AF patients who might benefit from combination therapy with calcium-antagonists or beta-blockers.