2010•Chinese Journal of Difficult and Complicated CasesRequires access
Effect of metoprolol plus small dose digoxin on improving ventricular rate and heart function of permanent atrial fibrillation with congestive heart failure
LI Zhon
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Abstract
Objective To study the effect of metoprolol plus small dose digoxin on improving ventricular rate and heart function of permanent atrial fibrillation with congestive heart failure.Methods A total of 94 patients with permanent atrial fibrillation and contraction heart failure were randomly divided into digoxin plus metoprolol combination treatment group(treatment group,n=47) and digoxin treatment group(control group,n=47).The unstable patients were controlled with drugs to improve cardiac function,other stable patients were underwent drugs therapy with diuretic,angiotensin converying enzyme inhibitor or angiotensinⅡreceptor antagonist,aspirin or warfarin.Besides of routine therapy,the control group underwent digoxin at the dose of 0.125 mg/d,while the treatment group underwent digoxin and metoprolol at the dose of 12.5～75 mg/d.At the time point pre therapy and after 12 weeks treatment, the 12 lead electrocardiogram,dynamic ECG,left ventricular ejection fraction(LVEF) and 6-minute walk test were examined and followed.Results(1) After treatment,the totally efficiency rate was significantly increased in treatment group than that of control group(100.0%vs 91.5%,P0.05).(2)There was statistical significance of silent ventricular rate,the LVEF in both two groups(P0.05).specially after actively ventricular rate(P0.01).(3)There was no serious complication in both two groups.Conclusion The metoprolol plus small dose digoxin may safely and effectively control ventricular rate and improve heart function in permanent atrial fibrillation with congestive heart failure.