![]() Atrial fibrillation and atrial flutter are defined as abnormal heart rhythms that arise from improper electrical activity of the heart which lead to ineffective mechanical contraction. The atriums of the heart receive blood returning from the body and pump it further ahead to the ventricles. Atrial fibrillation and atrial flutter also have a significant impact on healthcare costs and account for approximately 1% of the National Health Service budget in the UK and approximately 26 billion dollars of annual expenses in the USA. The risks of both cerebral stroke and heart failure are increased nearly fivefold in patients with atrial fibrillation and atrial flutter, and an estimated 20% of every stroke may be due to atrial fibrillation. Atrial fibrillation and atrial flutter are associated with an increased risk of death and morbidities. The prevalence of both atrial fibrillation and atrial flutter are increasing possibly because of a greater life expectancy in the general population, an increased prevalence of risk factors for atrial fibrillation and atrial flutter, and an improved ability to suspect and diagnose the arrhythmias. Atrial flutter, another arrhythmia, occurs less often with an incidence of approximately 200,000 new patients per year in the USA. Systematic review registrationĪtrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world. The results of this systematic review have the potential to benefit millions of patients worldwide as well as healthcare economy. For both our primary and secondary outcomes, we will create a ‘Summary of Findings’ table based on GRADE assessments of the quality of the evidence. We will perform our meta-analyses of the extracted data using Review Manager 5.3 and Trial Sequential Analysis ver. Any eligible trial will be assessed and classified as either at high risk of bias or low risk of bias, and our primary conclusions will be based on trials with low risk of bias. We plan to search the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, LILACS, Science Citation Index Expanded on Web of Science, and BIOSIS to identify relevant trials. We plan to include all relevant randomised clinical trials comparing digoxin with placebo, no intervention, or with other medical interventions. This protocol for a systematic review was conducted following the recommendations of Cochrane and the eight-step assessment procedure suggested by Jakobsen and colleagues. This protocol for a systematic review aims at identifying the beneficial and harmful effects of digoxin compared with placebo, no intervention, or with other medical interventions for atrial fibrillation and atrial flutter. ![]() The evidence on the benefits and harms of digoxin compared with placebo or with other medical interventions is unclear. Lowering the heart rate may theoretically prevent the development of heart failure and tachycardia-mediated cardiomyopathy. In the management of atrial fibrillation and atrial flutter, it is often necessary to use medical interventions to lower the heart rate. Patients with atrial fibrillation and atrial flutter have an increased risk of death and morbidities. Atrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world.
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