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Intravenous digoxin in acute atrial fibrillation

DOI: http://dx.doi.org/ 649-654 First published online: 2 April 1997


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

  • Atrial fibrillation
  • digoxin
  • controlled clinical trial
  • therapy


    • Revision received September 30, 1996.
    • Accepted October 21, 1996.