Amiodarone versus digoxin for acute rate control of atrial fibrillation in the emergency department

Groups were not matched; total sample size was limited by a relatively low number of patients receiving digoxin during the study period. [...]evaluation is warranted to provide additional insight on choosing an optimal second-line drug for these patients.Funding This research did not receive any spe...

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Published in:The American journal of emergency medicine 2022-12, Vol.62, p.133-135
Main Authors: Mason, Jessica M., Krenz, James R., Koehl, Jennifer L., Fuh, Lanting, Nagurney, John T., Wilcox, Susan R., Hayes, Bryan D.
Format: Article
Language:English
Subjects:
Amiodarone
Atrial fibrillation
Body weight
Calcium channels
Cardiac arrhythmia
Creatinine
Digoxin
Diltiazem
Drug dosages
Electrocardiography
Emergency department
Emergency medical care
Fibrillation
Hypotension
Magnesium
Metoprolol
Patients
Ventricular rate control
Verapamil
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Summary:Groups were not matched; total sample size was limited by a relatively low number of patients receiving digoxin during the study period. [...]evaluation is warranted to provide additional insight on choosing an optimal second-line drug for these patients.Funding This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.Declaration of Competing Interest None. Baseline characteristic Amiodarone (n = 37) Digoxin (n = 37) P Age, yearsa 69 (57–79) 71 (61–81) 0.38 Male sex, n (%) 20 (54.1) 20 (54.1) 1 Race, n (%) 0.60 Hispanic 2 (5.4) 1 (2.7) Non-Hispanic 33 (89.2) 32 (86.5) Unknown/Not Reported 2 (5.4) 4 (10.8) Actual body weight, kga 79.5 (65.8–94.6) 80.5 (65.5–100.4) 0.62 Creatinine clearance, mL/mina,b 56.4 (35.4–80.3) 52.2 (35.2–66.2) 0.45 Initial cardiac rhythm, n (%) 1 Atrial fibrillation 35 (94.6) 34 (91.9) Atrial flutter 2 (5.4) 3 (8.1) HR on arrival, bpma 150 (131–166) 143 (125–156) 0.19 HR just prior to drug administration, bpma 138 (129–149) 136 (131–145) 0.52 SBP on arrival, mmHga 129 (101–147) 128 (118–147) 0.59 Potassium level on initial BMP, mEq/La 4.1 (3.8–4.4) 4.2 (3.9–4.7) 0.33 Magnesium level on initial BMP, mg/dLa 2 (1.8–2.1) 1.9 (1.6–2.1) 0.11 History of HF, n (%) 9 (24.3) 12 (32.4) 0.44 LVEF, %a 41 (21–54) 46 (36–62) Home beta-blocker PTA, n (%) 19 (51.4) 20 (54.1) 0.82 Home calcium channel blocker PTA, n (%) 3 (8.1) 4 (10.8) 1 Home anti-arrhythmic PTA, n (%) 3 (8.1) 0 0.24 Other treatment prior to drug administration while in ED, n (%) Metoprolol IV or PO 21 (56.8) 30 (81.1) 0.024 Diltiazem IV or PO 17 (45.9) 19 (51.4) 0.64 Verapamil IV or PO 0 0 – Magnesium IV 29 (78.4) 19 (51.4) 0.015 Table 1 Comparison of baseline characteristics.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2022.09.001