ABSTRACT
Aim: We investigated the use of intravenous digoxin for atrial fibrillation on ISLHD’s Wollongong Hospital’s general wards. The primary aim was to inform the design of a new drug guideline. Methods: All results for e-meds use of intravenous digoxin in 2020 for ISLHD were accessed. They were filtered to Wollongong Hospital. Whilst the emergency department and intensive care unit were excluded as critical care areas, other key units with cardiac monitoring capacity (Coronary Care Unit, Neuro-high Intensity Unit and COVID-19 ward) were included. Results: 45 patients received intravenous digoxin on inpatients’ wards in Wollongong Hospital in 2020. The average age was 77 years, with 28 (62%) having known AF. 23 patients (51%) were on cardiac monitoring. 5 patients (11%) were haemodynamically unstable. 10 patients (22%) were not prescribed rate control when intravenous digoxin was initiated, and 4 patients (9%) were not taking their rate control due to swallowing issues or hypotension. 31 patients (69%) had a rapid response and cardiology was involved in 22 (49%) of the patients. Only one patient had a documented bradyarrhythmia. Conclusion: The above data informed a new drug guideline for intravenous digoxin on general wards. It specifically addressed low rates of cardiology involvement and earlier involvement in uncontrolled AF. It also included an emphasis on the utilisation of cardiac monitoring for haemodynamically unstable patients requiring intravenous digoxin.