[The use of digitalis glycosides in atrial fibrillation].
The role of cardiac glycosides for conversion of atrial fibrillation to simus rhythm is controversially discussed. In a prospective study, 45 patients with paroxysmal atrial fibrillation were randomly assigned to one of three treatment groups (of 15 patients each). Group I received oral digoxin, three times 0.125 mg up to twice 0.25 mg daily; group II oral digoxin twice 0.125 mg and quinidine hydrogen sulphate 750-1000 mg daily; group III oral digoxin three times 0.125 mg and flecaimide 200-300 mg daily. During a mean observation period of 11 months, digoxin alone was significantly less effective (p < 0.05) in reducing or suppressing paroxyms of atrial fibrillation than digoxin plus quinidine or flecainide. The use of digoxin remains a mainstay of treatment for rate control in atrial fibrillation. To convert atrial fibrillation to sinus rhythm, however, the addition of a type I or III antiarrhythmic agent is necessary.
Medizinische Klinik I, Universität München, Klinikum Grosshadern.
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Knez
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Haberl
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Steinbeck
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004077:Digoxin / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D005424:Flecainide / Q000008:administration & dosage* / Q000009:adverse effects; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011802:Quinidine / Q000008:administration & dosage* / Q000009:adverse effects; D013614:Tachycardia, Paroxysmal / Q000188:drug therapy* / Q000503:physiopathology
D004077:Digoxin; D011802:Quinidine; D005424:Flecainide
Der Einsatz von Digitalisglykosiden bei Vorhofflimmern.