Is there a role for digoxin in atrial fibrillation without heart failure?

Digoxin remains one of the most frequently prescribed drugs in the management of atrial fibrillation. The main indications for digoxin in atrial fibrillation are restoration of sinus rhythm, prevention of recurrence and slowing of the ventricular rate. However, none of these effects of digoxin have been confirmed in placebo controlled studies. In addition, recent reports suggest increased mortality in patients with atrial fibrillation without heart failure taking digoxin. The aim of this article is to review the role of digoxin in atrial fibrillation without heart failure.