Digitalis: is it useful in congestive heart failure in patients in normal sinus rhythm?
The value of digoxin in the patient in normal sinus rhythm with chronic congestive heart failure continues to be controversial. Although many patients taking digoxin have no clinical deterioration after its discontinuance, there is a subgroup of patients (up to 30% of the total group) who demonstrate clinical deterioration on digoxin withdrawal. Patients with an S3 gallop and an enlarged left ventricle are especially likely to benefit from digoxin therapy. Furthermore, there is good evidence in patients with congestive heart failure that there is a persistent, chronic, positive inotropic effect with digoxin. Since digitalis is the only presently available, chronic, oral positive inotropic drug capable of increasing stroke volume at any given filling pressure, it should be used in patients with congestive heart failure.
Cheitlin
M D
MD
University of California School of Medicine, San Francisco General Hospital.
D004071:Digitalis Glycosides / Q000009:adverse effects / Q000627:therapeutic use*; D004077:Digoxin / Q000009:adverse effects / Q000627:therapeutic use; D004232:Diuretics / Q000494:pharmacology; D006333:Heart Failure / Q000188:drug therapy*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D009200:Myocardial Contraction / Q000187:drug effects; D005082:Physical Exertion / Q000187:drug effects; D013375:Substance Withdrawal Syndrome / Q000209:etiology
D004071:Digitalis Glycosides; D004232:Diuretics; D004077:Digoxin