Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Intravenous digoxin in acute atrial fibrillation
Results of a randomized, placebo-controlled multicentre trial in 239 patients
The Digitalis in Acute Atrial Fibrillation (DAAF) Trial Grouprevised 30 September 1996; accepted 21 October 1996.
Correspondence: Björn Hornestam, MD, Division of Cardiology, Department of Internal Medicine, Östra University Hospital, S-416 85 Göteborg, Sweden
Abstract
AIMS: The DAAF Trial was designed to investigate whether digoxin, within 16 h of its use, increases the rate of conversion to sinus rhythm in patients with acute atrial fibrillation.
METHODS AND RESULTS: In a randomized, double-blind multicentre trial the effects of intravenous digoxin and placebo, (mean dose 0·88±0·35 mg and 0·96±0·37 mg) were compared in 239 patients with a mean age of 66·2±13·0 years and atrial fibrillation of, at most, 7 days' duration. The mean arrhythmia duration was 21·7±30·4 h and baseline heart rate 122·0±23·0 beats. min–1. At 16 h, 46% of the placebo group and 51% of the digoxin group had converted to sinus rhythm, (ns). Time to sinus rhythm was shorter in the digoxin group, but the difference was not significant. Digoxin had a pronounced and rapid effect on heart rate, which was already significant at 2 h; 104·6±20·9 beats. min–1 vs 116·8±22·5 beats. min–1 (P=0·0001).
CONCLUSION: Acute intravenous treatment with digoxin does not increase the rate of conversion to sinus rhythm, but has a fast acting and clinically significant effect on heart rate and should remain an alternative in haemodynamically stable patients
Key Words: Atrial fibrillation • digoxin • controlled clinical trial • therapy
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