Effect of Digoxin vs Bisoprolol for Heart Rate Control in Atrial Fibrillation on Patient-Reported Quality of Life: The RATE-AF Randomized Clinical Trial
RCT (n=160) found no difference in the SF-36 physical component summary score (quality of life measure) at 6 months for digoxin vs bisoprolol in the treatment of permanent atrial fibrillation. Authors recommend basing decisions about treatment on other endpoints.
Source:
Journal of the American Medical Association
SPS commentary:
A related editorial comments that on the basis of these results, low-dose digoxin may be considered a viable alternative to β-blockers to safely achieve heart rate control in patients with permanent atrial fibrillation. The relatively low dose of digoxin (mean, 161 µg/d) proved to be sufficient for heart rate control while avoiding the threat of digoxin toxicity. Because this trial was small and open label in design however, the results may not markedly change the current clinical practice guidelines for heart rate control in atrial fibrillation. Still, among patients with permanent atrial fibrillation who do not tolerate β-blockers or calcium channel blockers, or who do not adequately respond to these drugs, digoxin may be useful to consider as a second-line agent.