Amiodarone vs. Digoxin for Ventricular-Rate Control in Patients with Atrial Fibrillation at the Emergency Department
Yuksen C, MD, PhD1, Sricharoen P, MD1, Jenpanitpong C, PMD1, Satainrum K, PMD1, Sukkho T, PMD1, Sawanyawisuth K, MD, PhD2, Sittichanbuncha Y, MD1
Affiliation : 1 Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand 2 Department of Medicine, Faculty of Medicine, Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, and Research and Diagnostic Center for Emerging Infectious Diseases (RDCEID), Khon Kaen University, Khon Kaen, Thailand
Objective : To compare an efficacy of amiodarone and digoxin in terms of rate control in patients with atrial fibrillation (AF) with
rapid ventricular response at the emergency department.
Materials and Methods : The present study was a descriptive, retrospective study conducted at the University Hospital. The inclusion
criteria were age over 18 years, presenting at the emergency room with AF and heart rate over 120 beats/min, and systolic blood
pressure over 90 mmHg. There were four clinical outcomes examined including successful heart rate control, heart rate difference,
treatment duration, and vital signs after treatment.
Results : During the study period, there were 147 patients who met the study criteria. Of those, 85 (57.83%) received amiodarone
treatment. Regarding treatment outcomes, the amiodarone group had a significantly higher proportion of patients who achieved
successful heart-rate control rate than the digoxin group (89.41% vs. 51.61%; p<0.001). Patients who received amiodarone were
1.4-times more likely to achieve a normal heart rate than digoxin (95% CI = 1.2 to 1.7 times, p-value <0.001). The two groups were
comparable in terms of the other outcomes.
Conclusion : Intravenous amiodarone was able to control ventricular rate in AF patients better than digoxin. In settings in which
access to intravenous antiarrhythmic agents is limited, amiodarone may be a potential alternative agent.
Keywords : Amiodarone, Digoxin, Ventricular rate, Outcomes
