Digoxin has been a stalwart in the management of atrial fibrillation for several decades. Its primary use is in the treatment of atrial fibrillation for rate control and heart failure.1,2 Digoxin (Digitalis purpurea or purple foxglove) is a cardiac glycoside and was discovered by botanist Sir William Withering in 1785 and used to treat cardiac dropsy (that is, heart failure).3 It was only formally approved in the treatment of heart failure in the 1990s and is used cautiously due to its narrow therapeutic window (especially in those with renal impairment). Digoxin is also associated with adverse effects and multiple drug interactions.4 For example beta-blockers, anticholinergics and calcium channel blockers all increase the concentration of digoxin. However, despite its frequent use in cardiac patients, there is some ambivalence in the literature on its benefits that can be confusing for clinicians and patients alike.
- atrial fibrillation
- Digitalis purpurea