[Is digoxin effective in the treatment of heart insufficiency in patients with sinus rhythm?].
Since its introduction in 1785, digitalis has been the cornerstone in the treatment of heart failure, although there during the last 20 years have been an increasing number of critical voices questioning its use in patients with sinus rhythm. In 1997 the Digitalis Investigation Group published the so far largest randomized trial on the use of digoxin in patients with heart failure (DIG-trial). All the included patients had sinus rhythm, and all received an ACE-inhibitor. Digoxin had no effect on mortality, but caused a decrease in hospitalizations. Based on the DIG-study, several minor clinical trials and two large withdrawal studies (RADIANCE and PROVED) it now seems clear that digoxin still has a role in the management of heart failure, not only in patients with atrial fibrillation, but also in patients with sinus rhythm.
Henriksen
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OM
H:S Bispebjerg Hospital, Medicinsk Center.
Gadsbøll
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D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001146:Arrhythmia, Sinus / Q000150:complications / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic; D004077:Digoxin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D016032:Randomized Controlled Trials as Topic
D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D004077:Digoxin