Factors Influencing Digoxin Efficacy in Supraventricular Tachyarrhythmia: The Role of Hemoglobin and Renal Function

Background: Supraventricular tachycardia (SVT) is a common arrhythmia requiring effective rate control. As a cardiac glycoside Digoxin is mostly utilized in infants for this indication. However, factors influencing its efficacy in managing SVT in adult patients are not thoroughly evaluated. Our study investigates the impact of hemoglobin and renal function on digoxin's ability to achieve rate control in adult SVT patients. Methods: We conducted a retrospective, single-center observational study with 167 adult patients presenting with SVT and treated with digoxin. Patients were categorized into Rate Control Group (RCG, n=58) and Non-Rate Control Group (N-RCG, n=109) based on the success of rate control. Clinical and laboratory parameters, including hemoglobin, renal function (GFR, renal failure), and patient outcomes (discharge, hospital/ICU admission) of both patient groups were analyzed and compared. Results: Patients achieving rate control (RCG) exhibited significantly higher hemoglobin levels (13.6 ± 2.5 g/dL vs. 12.7 ± 2.5 g/dL, p=0.010) and GFR (60.7 ± 27.3 vs. 58.7 ± 25.5 ml/min/1.73m2, p=0.015), with lower incidence of renal failure (3.4% vs. 17.4%, p=0.009) compared to N-RCG. Multivariate logistic regression revealed that hemoglobin remained a significant independent positive predictor of rate control (Adjusted OR: 1.154, 95% CI: 1.009-1.321, p=0.037), while renal failure and GFR did not retain statistical significance. No significant difference was observed in overall patient outcomes (discharge, hospital/ICU admission) between the groups (p=0.302). Conclusion: Higher hemoglobin levels independently predict successful rate control with digoxin in adult SVT patients. While renal function is still critical for digoxin pharmacokinetics, its direct influence on rate control success may be confounded by other factors. Further research is warranted to explore the mechanisms linking hemoglobin and GFR to digoxin efficacy and the long-term clinical implications of rate control.