Key clinical point: Results of the first-ever long-term randomized comparison of digoxin versus a beta-blocker indicate that digoxin may a contender for first-line treatment for rate control in patients with permanent atrial fibrillation and heart failure symptoms.

Major finding: There were five times fewer adverse events with digoxin than with bisoprolol for rate control in older patients with permanent atrial fibrillation and heart failure symptoms.

Study details: RATE-AF was a prospective, unblinded clinical trial in which 160 elderly patients with permanent atrial fibrillation and heart failure symptoms were randomized to bisoprolol or digoxin for rate control and followed for 12 months.

Disclosures: The presenter reported having no financial conflicts regarding the study, which was funded by the U.K. National Institute for Health Research, the British Heart Foundation, and the European Union.