February 2021 – When palliating heart failure with difficult to control atrial fibrillation, remember our old friend digoxin.
Consider Mr. Jones: His atrial fibrillation is marginally controlled but he can no longer tolerate any rate-controlling medications that lower his blood pressure, as he is falling with significant orthostatic hypotension.
Digoxin may improve quality of life and we find it a better choice for these patients when standing blood pressures are low.
Further reading:
Mark S. Link, MD reviewing Kotecha D et al. JAMA 2020 Dec 22/29 Curfman G. JAMA 2020 Dec 22/29
Digoxin was equivalent to a beta-blocker for quality of life in patients with AF and heart failure.
For more information contact Dr. Leslie Estep or Dr. Anita Meyer at Hospice of the Northwest, 360-814-5550, or lestep@hospicenw.org or ameyer@hospicenw.org