Why the study?
Does digoxin compared to diltiazem increase ventricular premature beats in patients with chronic atrial fibrillation?
Does digoxin compared to diltiazem increase ventricular premature beats in patients with chronic atrial fibrillation?
In patients with chronic atrial fibrillation, digoxin is associated with a higher incidence of ventricular premature beats compared to diltiazem, which may theoretically predispose to serious arrhythmias.
Answers are grounded in this paper and cite their sources.
Digoxin associated with more ventricular premature beats than diltiazem in chronic AF; hypothesis-generating and should not yet change practice.
In eight patients with chronic atrial fibrillation, treatment with digoxin (plasma drug concentration 1.3 to 2.0 nmol l-1) was associated with a significantly higher incidence of ventricular premature beats (VPBs) (mean 22.8 h-1) than diltiazem 120 mg three times daily (mean 6.8 h-1) (P less than 0.05). Seven out of the eight patients showed an increase in numbers of VPBs recorded over 24 h during treatment with digoxin when compared with diltiazem. The clinical importance of these results is unclear, but atrial fibrillation and ischaemic heart disease frequently co-exist, and increases in ventricular ectopy may predispose to serious ventricular arrhythmias following myocardial infarction.
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Lewis et al. (1988) studied this question.
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