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Aug 22, 2014

Safety Concerns About AFib Drug Digoxin

New study raises safety concerns about use of the common heart rate medication in atrial fibrillation patients.

A new study raises safety concerns about the use of a common heart rate medication, digoxin, in patients with atrial fibrillation. 

Atrial fibrillation, often referred to as AFib, is the most common type of irregular heartbeat, affecting an estimated 2.7 million Americans. Left untreated, atrial fibrillation doubles risk of death and causes a 4-to-5-fold increased risk for stroke. Fortunately, with proper treatment, patients with AFib can help control their condition and drastically reduce risk of complications. However, the widely used AFib drug digoxin may carry more risk than experts realized. 

Digoxin is one of the oldest heart drugs, most commonly used to treat AFib and heart failure. Although past studies showed that digoxin is safe in heart failure patients, fewer studies were performed in patients with AFib—until now.

Published in the Journal of the American College of Cardiology, this study followed more than 122,000 patients diagnosed with AFib between 2004 and 2008. Using data from the U.S. Department of Veterans Administration Health Care System, researchers then compared survival rates of patients based on their prescribed treatment. 

Unfortunately, they found that patients taking digoxin had a 20% greater risk of death than those not taking the drug. Nearly one-fourth of study participants used digoxin and across the United States, digoxin is used every day by millions of patients. 

Despite obvious safety concerns raised by this study, authors don’t encourage doctors to take all of their patients off the drug. However, investigators suggest that physicians consider alternatives to digoxin in managing patients with AFib and educate patients about the known risks and benefits of using the drug. In addition, authors encourage future research on the topic to better evaluate the safety of digoxin use in AFib patients. Although this study was the largest of its kind, gold-standard clinical trials are needed to properly evaluate the potential risks associated with digoxin use.

Questions for You to Consider

  • What is atrial fibrillation?

  • Atrial fibrillation is an irregular heart rhythm caused by abnormal, chaotic electrical impulses in the heart’s upper chambers, the atria. These electrical impulses, which interfere with the heart’s natural pacemaker, fire so rapidly the atria cannot beat with a regular rhythm or squeeze out blood effectively. Instead, they merely quiver while the ventricles, the heart’s lower chambers, beat rapidly.
  • How is atrial fibrillation treated?
  • Depending on the individual needs of each patient, treatment options for atrial fibrillation include medication and/or surgical or nonsurgical procedures. The goal of treatment is often to promote a normal heartbeat, address any underlying medical issues when possible, reduce risk for heart attack and stroke and improve quality of life.

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