Yet another study has shown that digoxin, a drug commonly used to treat patients with atrial fibrillation is associated with a 71% higher risk of death and a 63% higher risk of hospitalisation among adults.

A 2013 study had revealed digoxin was associated with a 72% higher rate of death among adults with newly diagnosed systolic heart failure.

A Stanford study of over half a million cases had also shown the potential risks of using digoxin, which has not been rigorously tested.

Derived from digitalis, digoxin has been used for more than a century for heart-rate control in patients with atrial fibrillation.

A recent Kaiser Permanente study of nearly 15,000 adults diagnosed with atrial fibrillation and no prior heart failure or digoxin use found a significantly higher rate of death and hospitalisation in digoxin users compared with non-users.

"Digoxin remains commonly used for rate control in atrial fibrillation, but very limited data exist to support this practice — mostly small, older clinical studies with very limited follow-up that did not assess the long-term effects of digoxin on mortality or hospitalization," said Alan S Go, MD, senior author of the study and research scientist at the Kaiser Permanente Division of Research in Oakland, California.

The study was published online on 21 November in the journal Circulation: Arrhythmia and Electrophysiology.

Atrial fibrillation is a common form of irregular and often abnormally fast heartbeat that has been linked to a rise in risk for stroke.

It has strong associations with other cardiovascular diseases, such as heart failure, coronary artery disease (CAD), valvular heart disease, diabetes mellitus and hypertension.

Experts have been cautioning against the use of digoxin except in some cases. Beta blockers or calcium channel blockers have been suggested as a better alternative.