Digoxin in advanced heart failure patients: A question of rhythm

Abstract

Digoxin therapy may improve the prognosis of advanced HF patients with AF under optimal medical therapy. However, no benefit of digoxin was demonstrated for patients in SR. These results may help to improve patient selection for digoxin therapy.

Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data

“…Study descriptors are summarised in table A in appendix 1. Of the 42 studies, 26 were retrospective or prospective cohorts,6 7 25 28 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 nine were post hoc analyses of randomised trials,20 21 60 61 62 63 64 65 66 and seven were randomised on the basis of digoxin 930 31 67 68 69 70 The length of follow-up (weighted average) was 3.7 (SD 2.4) years with a range of 0.25-8.2 years.…”

“…26 Studies by Freeman and colleagues27 and Whitbeck and colleagues20 were excluded from the quantitative meta-analysis as digoxin was assessed in a time dependent fashion, whereas all other studies assessed digoxin at baseline. Jorge and colleagues28 and Domanski and colleagues29 were not meta-analysed as crude event rates were not presented. Gheorghiade and colleagues21 and Whitbeck and colleagues20 provided unadjusted data derived from the same cohort (the AFFIRM trial), albeit with different patient inclusion.…”

Digoxin in Patients With Advanced Heart Failure and Sinus Rhythm Submitted to Cardiac Resynchronization Therapy—Is There Any Benefit?

“…Besides, a high percentage of patients were taking β-blockers, which might neutralize the risk of arrhythmic death associated with the use of DG by attenuating stress-induced reductions in serum potassium. 24…”