Why the study?
Does digoxin adequately control heart rate during exercise in patients with chronic atrial fibrillation?
Does digoxin adequately control heart rate during exercise in patients with chronic atrial fibrillation?
In patients with chronic atrial fibrillation, therapeutic serum digoxin concentrations do not adequately control heart rate during regular daily activities or exercise, demonstrating that resting heart rate is an unreliable guide for adequate rate control.
Digoxin monotherapy fails to control exercise heart rate in chronic AF; challenges its standalone use and supports trials of combination regimens.
Heart rate at rest and during increasing workloads was measured in a double blind study of 12 patients with chronic atrial fibrillation when serum concentrations of digoxin were nil and at low and high therapeutic values. Twelve normal subjects were studied for comparison. The heart rate at all levels of exercise in most patients with atrial fibrillation was not adequately controlled by any serum digoxin concentration tested despite a reduction in heart rate with increasing serum digoxin concentrations. Control of the resting heart rate, even in patients with high serum digoxin concentrations, did not ensure adequate control of the heart rate during work rates equivalent to regular daily activities.
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Beasley et al. (1985) studied this question.
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