Home > Cardiology > ESC 2020 > Late-Breaking Science > Digoxin improves symptoms in stable patients with permanent AF

Digoxin improves symptoms in stable patients with permanent AF

Presented By
Prof. Dipak Kotecha, University of Birmingham, UK
Conference
ERS 2020
Trial
Phase 4, RATE-AF trial
The RATE-AF trial showed a similar effect of low-dose digoxin on both heart rate and the physical component of quality of life compared with beta-blockers [1]. Yet, digoxin-treated patients showed significantly better symptom improvement, a reduction in natriuretic peptides, and substantially less adverse events without compromising left ventricular function. These results suggest that digoxin could be considered as a first-line approach for rate control in stable patients with permanent atrial fibrillation (AF). Beta-blockers are commonly used for rate control due to their beneficial effects in heart failure with reduced ejection fraction. However, the observed mortality benefit does not appear to extend to those with AF in double-blind, randomised trials. Data on digoxin suffers from prescription bias, as doctors typically preserve digoxin for sicker, older patients with more comorbidities. Although digoxin has been in use since 1785, no longer-term tri...


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