Friday October 19, 2007
Acute A. fib. and Digoxin


Q: 44 year old male with CHF went into Atrial fibrillation with RVR (Rapid Ventricular Rate) of 160 to 180 beats per minute. You ordered Digoxin 0.25 mg IV but after 15 minutes, there is no response ?


Answer: Digoxin is an effective medicine for control of Atrial fibrillation associated RVR particularly in patients with congestive heart failure and left ventricular systolic dysfunction. But this is of importance to know that Digoxin is not a treatment for very acute management of A.fib. The onset of action is usually at 30 minutes with a peak effect in 2 - 3 hours.