Common Drug for Irregular Heartbeat Tied to Worse Outcomes

By Alan Mozes HealthDay Reporter

WEDNESDAY, March 4, 2015 (HealthDay News) -- Patients who take the heart rhythm drug digoxin may face a nearly 30 percent greater risk of death than patients not taking the drug, a review of prior research suggests.

The analysis also suggests that digoxin may increase the risk for death by 60 to 70 percent among patients with both the heart rhythm disorder known as atrial fibrillation and kidney failure.

The findings stem from an in-depth look at 19 studies involving nearly a half million atrial fibrillation patients, many of whom were prescribed digoxin (brand names: Digox, Lanoxin) as a way to rein in irregular heartbeats.

"Between 15 to 20 percent of atrial fibrillation patients use this drug to control this disorder of the heart, which is very prevalent among older age groups," said study lead author Dr. Waqas Qureshi, a clinical and research fellow of cardiology at Wake Forest School of Medicine in Winston-Salem, N.C. Currently, the American Heart Association and the American College of Cardiology include digoxin as a first-line therapy for the condition, he said.

"We found a very strong signal that a significant portion of digoxin users faced an increased risk for death, versus those who took other medications," Qureshi added. "Even though this is just a pooling of data from other studies which needs to be confirmed by clinical trials, the message for now is that other first-line medications -- such as beta-blockers and calcium channel blockers -- should be tried first."

Qureshi and his colleagues are scheduled to present their findings March 15 at the annual meeting of the American College of Cardiology, in San Diego. Research presented at meetings is usually considered preliminary until published in a peer-reviewed medical journal.

Atrial fibrillation is a quivering or irregular heartbeat that can lead to blood clots, stroke and heart failure, according to the American Heart Association. It estimates that 2.7 million Americans have atrial fibrillation.

Qureshi said digoxin is not an unfamiliar drug. The foxglove flower extract at its source was harnessed thousands of years ago as a beautifying agent hailed for its ability to dilate pupils. Its usefulness for heart disease sufferers was identified in the 17th century.

Today, experts support digoxin as one of the first drugs of choice for sicker patients with multiple health conditions, Qureshi said.

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Common Drug for Irregular Heartbeat Tied to Worse Outcomes