Related Experiment Video
Updated: Feb 5, 2026
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Is There Still a Role for Digoxin in the Management of Atrial Fibrillation?
Jeffrey B Washam1, Manesh R Patel2
1Duke Heart Center, Duke University Medical Center, Box 3943, Durham, NC, 27710, USA. jeff.washam@duke.edu.
Insights
Digoxin use in atrial fibrillation patients without heart failure is linked to increased adverse outcomes. In heart failure patients, digoxin should be reserved for those with inadequate rate control or intolerance to other therapies.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Digoxin is a medication historically used for rate control in atrial fibrillation.
- Recent observational studies have re-evaluated its clinical outcomes.
Purpose of the Study:
- To review current evidence on digoxin's clinical outcomes in atrial fibrillation.
- To provide guidance on contemporary digoxin use in this patient population.
Main Methods:
- Review of recent observational analyses and clinical trial data.
- Synthesis of evidence regarding digoxin's safety and efficacy.
Main Results:
- Digoxin use in atrial fibrillation patients without heart failure is associated with increased adverse events.
- Evidence for increased risk in atrial fibrillation patients with heart failure is inconsistent.
- Digoxin should generally be avoided in patients without heart failure.
Conclusions:
- Reserve digoxin for atrial fibrillation patients with heart failure who have inadequate rate control or are intolerant to other treatments.
- Careful consideration of risks and benefits is crucial for digoxin therapy in atrial fibrillation.
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.
Related Concept Videos
03:03Amyloid Fibrils
Amyloid deposits were observed as early as 1639 in the liver and the spleen. In 1854, Rudolph Virchow performed iodine staining,...
03:03Amyloid Fibrils
01:11Fibril-associated Collagen
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
01:02Role of Septins
Cellular Functions of Septins
Recent studies have revealed the multifaceted roles of septins in various cellular processes such as cytokinesis, ciliogenesis, and neurogenesis. Septins act as scaffolds and...
01:23The Role of Culture
01:26Tonsillitis II: Management