There have been recent debates on a possible reduced efficacy of beta-blockers as well as safety issues with digoxin when treating HF patients with AF. The benefit of beta-blockers on survival may be lower in patients with HF with reduced ejection fraction when AF is present.

In a systematic review of randomized studies comparing digoxin and calcium channel blockers and beta-blockers with placebo on duration of treadmill exercise, digoxin resulted in increase in exercise tolerance in 2 of 4 trials, despite no effect on exercise heart rate; blocker therapy resulted in reduction in exercise tolerance in 3 of 9 trials ...

2024年5月23日 · The latest guideline recommends the prescription of both beta-blockers and digoxin in patients with HF and reduced ejection fraction (HFrEF) but does not prefer digoxin over non-dihydropyridine calcium channel blockers as the second-line treatment in patients with HF and preserved ejection fraction (HFpEF) [1].

2022年6月8日 · Compared to beta blocker, digoxin therapy was associated with increased all-cause mortality [hazard ratio (HR) 1.90 (95% confidence interval, CI, 1.48-2.44)], CV mortality [HR 2.18 (95% CI 1.47-3.21)], and non-CV mortality [HR 1.68 (95% CI 1.02-2.75)] with reduced quality of life [health utility score 0.555 (±0.406) vs. 0.705 (±0.346), P < 0.001...

2009年1月15日 · In patients with atrial fibrillation (AF) and heart failure (HF), beta blockers and digoxin reduce the ventricular rate, but controversy exists concerning how these drugs affect prognosis in this setting. This study compared the effects of beta blocker and digoxin on mortality in patients with both …

Digoxin remains the only (albeit weak) positive inotrope that is valuable in the management of chronic heart failure. β Adrenoceptor blockers have traditionally been avoided in patients with heart failure due to their negative inotropic effects.

2021年10月19日 · In this study, we aimed to evaluate the effects of digoxin over beta-blocker therapy among patients with AF from the contemporary European Society of Cardiology–European Heart Rhythm Association (ESC–EHRA) EURObservational Research Programme (EORP) AF General Long-Term Registry.

2009年1月15日 · Digoxin alone is associated with a worse survival chance, similar to that of patients without any rate control treatment. In patients with atrial fibrillation (AF) and heart failure (HF), both digoxin and β blockers reduce the ventricular rate and both may improve symptoms.

2021年11月23日 · A secondary analysis of a large data set collected by the Digitalis Investigation Group published in 2002 strongly suggested that women with heart failure, left ventricular ejection fraction ≤45% and receiving digoxin have a significantly increased risk of all-cause and cardiovascular death compared to their counterparts receiving placebo. 2 ...

2006年5月30日 · Digoxin was added in only 8% of patients before discharge despite the fact that they had signs and symptoms of heart failure while receiving diuretics, ACE inhibitors, or angiotensin receptor blockers (ARBs) and β-blockers. 9,10 This decrease in digoxin use is likely the result of several factors.