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The drug of choice to treatment of patient have atrial fibrillation and left ventricular heart failure is , the most common indications for digoxin are atrial fibrillation and atrial flutter with rapid ventricular response, but beta-blockers or calcium channel-blockers should be the first choice High ventricular rate leads to insufficient diastolic filling time. By slowing down the conduction in the AV node and increasing its refractory period, digoxin can reduce the ventricular rate. The arrhythmia itself is not affected, but the pumping function of the heart improves owing to improved filling.
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