Intravenous digoxin in acute atrial fibrillation. Results of a randomized, placebo-controlled multicentre trial in 239 patients. The Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group.
OBJECTIVE
The DAAF Trial was designed to investigate whether digoxin, within 16 h of its use, increases the rate of conversion to sinus rhythm in patients with acute atrial fibrillation.


RESULTS
In a randomized, double-blind multicentre trial the effects of intravenous digoxin and placebo, (mean dose 0.88 +/- 0.35 mg and 0.96 +/- 0.37 mg) were compared in 239 patients with a mean age of 66.2 +/- 13.0 years and atrial fibrillation of, at most, 7 days' duration. The mean arrhythmia duration was 21.7 +/- 30.4 h and baseline heart rate 122.0 +/- 23.0 beats.min-1. At 16 h, 46% of the placebo group and 51% of the digoxin group had converted to sinus rhythm, (ns). Time to sinus rhythm was shorter in the digoxin group, but the difference was not significant. Digoxin had a pronounced and rapid effect on heart rate, which was already significant at 2 h; 104.6 +/- 20.9 beats.min-1 vs 116.8 +/- 22.5 beats.min-1 (P = 0.0001).


CONCLUSIONS
Acute intravenous treatment with digoxin does not increase the rate of conversion to sinus rhythm, but has a fast acting and clinically significant effect on heart rate and should remain an alternative in haemodynamically stable patients.
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004077:Digoxin / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004562:Electrocardiography / Q000187:drug effects; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D013548:Sweden
D000889:Anti-Arrhythmia Agents; D004077:Digoxin