Inefficacy of digitalis in the control of heart rate in patients with chronic atrial fibrillation: Beneficial effect of an added beta adrenergic blocking agent

Daniel David, Elio Di Segni, Herman O. Klein, Elieser Kaplinsky

Research output: Contribution to journalArticlepeer-review

Abstract

The role of digoxin and the new beta adrenergic blocking agent, timolol, in controlling heart rate at rest and during exercise was investigated in 28 patients with chronic atrial fibrillation. Digoxin failed to prevent excessively rapid heart rates during mild to moderate exercise. Increasing digoxin blood levels from a mean of 0.6 to 1.8 ng/ml had no effect on heart rate either at rest or during exercise. The addition of timolol, 20 to 30 mg/day, resulted in a satisfactory and significant attenuation of the rapid heart rates both at rest and during exercise. Heart rates at rest were 91 and 98 beats/min in the patients with low and high digoxin dosage and rose to 135 and 139 beats/min, respectively, during exercise. Timolol reduced the heart rate to 67 at rest and to 92 beats/min during exercise. The effect of beta adrenergic blockade at rest was less pronounced in patients whose initial heart rates were below 90 beats/min. Digoxin alone may not suffice to control excessive heart rate in patients with chronic atrial fibrillation. The additional beta adrenergic blockade actually normalizes the heart rate response in these patients.

Original languageEnglish
Pages (from-to)1378-1382
Number of pages5
JournalAmerican Journal of Cardiology
Volume44
Issue number7
DOIs
StatePublished - Dec 1979

Fingerprint

Dive into the research topics of 'Inefficacy of digitalis in the control of heart rate in patients with chronic atrial fibrillation: Beneficial effect of an added beta adrenergic blocking agent'. Together they form a unique fingerprint.

Cite this