European journal of clinical pharmacology
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Eur. J. Clin. Pharmacol. · Oct 2007
Digoxin and mortality in atrial fibrillation: a prospective cohort study.
The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study showed that rhythm-control treatment of patients with atrial fibrillation (AF) offered no survival advantage over a rate-control strategy. In a subgroup analysis of that study, it was found that digoxin increased the death rate [relative risk (RR) = 1.42), but it was suggested that this may have been attributable to prescription of digoxin for patients at greater risk of death, such as those with congestive heart failure (CHF). No study has investigated a priori the effect of digoxin on mortality in patients with AF. This study aimed to address this question. ⋯ The results suggest that long-term therapy with digoxin is an independent risk factor for death in patients with AF without CHF.