A number of drugs tend to be more effective than digoxin for atrial fibrillation, although the medication still has a place in cardiac care. This medication has a long and established history in the treatment of abnormal heart rhythms, but studies suggest newer generation drugs are often more appropriate. Doctors continue to recommend digoxin for atrial fibrillation in specific cases, often in combination with other medications, and it can be effective in the treatment of some patients. Patients with concerns about their heart health and treatment options can discuss available choices with a cardiologist.
Digoxin is a derivative of foxglove, which has been used in the management of cardiac conditions since the 1700s. It works by slowing the heart rate and increasing the intensity of contractions. The medication can be particularly effective in the management of patients with left ventricular systolic dysfunction, especially when those patients are not very active. For other cases, alternative medications may be more appropriate.
One issue with using digoxin for atrial fibrillation is that it primarily acts on the resting heart rate. Patients who are more active may not experience the same level of rate control while on the medication because it cannot compensate for physical activity. These patients may need treatment with an additional or alternative medication. It is important to keep the heart rate under control at all times, and thus a medication that only works some of the time may not be desirable.
In addition, digoxin for atrial fibrillation does not have any demonstrated efficacy for converting the heart rhythm. Patients with an abnormal heart rhythm need conversion, a restoration to the normal heart rhythm, for successful treatment. Digoxin alone cannot bring a patient's heart back to the normal sinus rhythm; for this, the patient needs other drugs. For this reason, the drug is not safe to use in isolation for management of a patient with atrial fibrillation.
Cardiologists may recommend digoxin for atrial fibrillation as part of a larger overall plan for management of a patient's heart rate and rhythm. The patient may need to transition to beta blockers and other drugs for long term management of an abnormal heart rhythm. Options for care can depend on the type of problem the patient experiences. There can be a number of causes for atrial fibrillation and it is important to thoroughly evaluate the patient to learn about the specifics of the case and decide how to proceed with treatment.