Contrary to findings from observational studies which are inherently affected by bias, digoxin use in randomised controlled trials (RCTs) did not lead to excess mortality in our meta-analysis of 87 studies. There is evidence that digoxin can reduce heart failure-related deaths and hospitalizations. This has implications in treating concomitant atrial fibrillation and heart failure, with two RCTs currently underway to improve our evidence base.

In this interview, Asgher Champsi MD, and Alison L. Bailey MD, FACC discuss ESC Late-Breaker: DIG-META: Digoxin in heart failure and atrial fibrillation.

Related References:

1. Champsi, Asgher & Mitchell, Christian & Tica, Otilia & Ziff, Oliver & Bunting, Karina & Mobley, Alastair & Kotecha, Dipak. (2023). Digoxin in Patients with Heart Failure And/Or Atrial Fibrillation: A Systematic Review and Meta-Analysis of 5.9 Million Patient Years of Follow-Up. 10.2139/ssrn.4544769.
2. Alahmed AA, Lauffenburger JC, Vaduganathan M, Aldemerdash A, Ting C, Fatani N, Fanikos J, Buckley LF. Contemporary Trends in the Use of and Expenditures on Digoxin in the United States. Am J Cardiovasc Drugs. 2022 Sep;22(5):567-575. doi: 10.1007/s40256-022-00540-x. Epub 2022 Jun 24. PMID: 35739347; PMCID: PMC10263277.
3. Gerakaris A, Mulita F, Koniari I, Artopoulou E, Mplani V, Tsigkas G, Abo-Elseoud M, Kounis N, Velissaris D. Digoxin Impact on Heart Failure Patients with Atrial Fibrillation. Med Arch. 2022 Feb;76(1):23-28. doi: 10.5455/medarh.2022.76.23-28. PMID: 35422570; PMCID: PMC8976896.