Left Ventricular Performance During Acute Rate Control in Atrial Fibrillation: The Importance of Heart Rate and Agent Used
Key result
IV digoxin doubles LVEF decline per heart rate increase vs diltiazem in acute AF.
- P=0.048
- n=24
Why the study?
The relation between heart rate and left ventricular function during rate control in atrial fibrillation is incompletely understood.
Does intravenous digoxin improve left ventricular ejection fraction compared to intravenous diltiazem in patients with symptomatic recent onset rapid atrial fibrillation?
Population
24 patients with symptomatic recent onset rapid atrial fibrillation and rapid ventricular rate (> 110 bpm)
Comparison
Intravenous digoxin (13 mcg/kg) vs intravenous diltiazem (0.25 mg/kg bolus plus maintenance infusion)
Design
Randomized controlled trial
Follow-up
6 hours
Authors
Discussion
Loading...
Member takes
Implication
Supports digoxin as alternative to diltiazem in acute AF; extends RCT evidence on agent-specific EF responses.
Study Design
Type
RCT (n=24)
Structured PICO
Does intravenous digoxin improve left ventricular ejection fraction compared to intravenous diltiazem in patients with symptomatic recent onset rapid atrial fibrillation?
P
Population
24 patients (mean age 67 years) with symptomatic recent onset rapid atrial fibrillation and rapid ventricular rate (> 110 bpm) monitored for 6 hours.
I
Intervention
Intravenous digoxin (13 mcg/kg)
C
Comparator
Intravenous diltiazem (0.25 mg/kg bolus plus a maintenance infusion)
O
Outcome
Heart rate and left ventricular ejection fraction measured every 15 seconds for 6 hourssurrogate
Main Result
Absolute Event Rate: -0.34% vs -0.16%
p-value: p=0.048
In patients with acute atrial fibrillation, intravenous digoxin provides similar improvements in left ventricular ejection fraction compared to diltiazem despite less potent heart rate reduction.
Cite This Study
Pintér et al. (2003) conducted an RCT in symptomatic recent onset rapid atrial fibrillation and rapid ventricular rate (> 110 bpm) (n=24). intravenous digoxin vs. intravenous diltiazem was evaluated on ejection fraction vs heart rate slope (p=0.048). Intravenous digoxin resulted in a steeper ejection fraction vs heart rate slope compared to diltiazem (-0.34 vs -0.16, P=0.048) in patients with acute atrial fibrillation.